NPIMap

Organization Active NPI

Grace Medical Lab LLC

  • Clinical Medical Laboratory
  • Belzoni, MS
National Provider Identifier
1245989243
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
GRACE MEDICAL LAB LLC
Practice address
117 N Hayden St
Belzoni, MS 39038-3931
Phone
(662) 318-3002
NPI assigned
Mar 18, 2022
Organization subpart
No

Practitioners 1

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

National Provider Directory

National Provider Directory

Locations

117 N Hayden St
Belzoni, MS 39038
Phone (662) 247-1122

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Authorized official

Name
Sarah Myles, RNNPI 1942958822
Title
Lab Director
Phone
(662) 318-3002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

117 N Hayden St
Belzoni, MS 39038-3931

Mailing address

2533 Martin Lake Rd
Isola, MS 38754-4457
Phone (662) 836-8296

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1245989243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2533 MARTIN LAKE RD",
            "city": "ISOLA",
            "state": "MS",
            "postal_code": "387544457",
            "telephone_number": "662-836-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N HAYDEN ST",
            "city": "BELZONI",
            "state": "MS",
            "postal_code": "390383931",
            "telephone_number": "662-318-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "MYLES",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "662-318-3002",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belzoni, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.