Active NPI
Mmi Breast Center, Inc.
- Diagnostic Radiology Physician
- Scottsboro, AL
National Provider Identifier
1255384202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- MMI BREAST CENTER, INC.
- Practice address
- 1108B S Broad St
Scottsboro, AL 35768-2514 - Phone
- (256) 574-2883
- Fax
- (256) 259-9397
- NPI assigned
- May 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bart Medlen
- Title
- Owner
- Phone
- (256) 574-2883
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
1108B S Broad St
Scottsboro, AL 35768-2514
Mailing address
PO Box 242848
Montgomery, AL 36124-2848
Phone (334) 270-9914
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
510 Harley St
Scottsboro, AL 35768
Phone (205) 574-2883
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Huntsville, AL
- NPI 1053526988
-
- Diagnostic Radiology Physician
- Huntsville, AL
- NPI 1710947684
-
- Diagnostic Radiology Physician
- Gurley, AL
- NPI 1558435610
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1707436800000",
"number": "1255384202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 242848",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361242848",
"telephone_number": "334-270-9914",
"fax_number": "334-270-3195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108B S BROAD ST",
"city": "SCOTTSBORO",
"state": "AL",
"postal_code": "357682514",
"telephone_number": "256-574-2883",
"fax_number": "256-259-9397"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MMI BREAST CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-19",
"last_updated": "2024-02-09",
"certification_date": "2024-02-09",
"status": "A",
"authorized_official_last_name": "MEDLEN",
"authorized_official_first_name": "BART",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "256-574-2883",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Scottsboro, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.