Mid-South Imaging Center LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MID-SOUTH IMAGING CENTER LLC

Practice address

363 Southcrest Cir Ste 102
Southaven, MS 38671-4737

Phone

(662) 772-4615

NPI assigned

Jul 29, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gregory M Duckett

Title

Sr VP/Clo

Phone

(901) 227-5233

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dexter Hathaway Witte IV, M.D.

  • Diagnostic Radiology Physician
  • Charlottesville, VA
  • NPI 1174978449
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1245966324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "901-227-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 SOUTHCREST CIR STE 102",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714737",
            "telephone_number": "662-772-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP/CLO",
        "authorized_official_telephone_number": "901-227-5233",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micheal G Cook OD PC
• Anna Kathryn Michell, COTA/L
• Mid South Otolaryngology Associates P.C.
• Mid-Delta Hospice North Inc
• Mid-South Anesthesia Consultants, PLLC
• Mid-South Orthopedic Hospitalists LLC
• Lindsey Nicole Middleton, NP
• Midsouth Hospitalists, PC
• Midsouth Integrative Medical, Inc
• Midsouth Internal Medicine Physicians, PLLC

• Clinic/Center in Southaven, MS
• Providers in Southaven, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.