Iac Diagnostic Screening Lab

Primary specialty

HomemakerTaxonomy code 376J00000X

Legal business name

IAC DIAGNOSTIC SCREENING LAB

Practice address

928 Goodman Rd E Ste 202
Southaven, MS 38671-8824

Phone

(662) 715-9623

NPI assigned

Jul 19, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Brooke FarmerNPI 1033947965

Title

President

Phone

(662) 715-9623

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Brooke Farmer

  • Homemaker
  • Southaven, MS
  • NPI 1033947965
  NPD Authorized official

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1265270441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 GOODMAN RD E STE 202",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386718824",
            "telephone_number": "662-715-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 GOODMAN RD E STE 202",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386718824",
            "telephone_number": "662-715-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAC DIAGNOSTIC SCREENING LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-715-9623",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmily Thomas Hurdle, FNP
• Erin Lynn Hurt, M.S., CF-SLP
• Mary Hutcheson, P-LPC
• Quentin Hutchinson, M.S., BCBA, LBA
• Victoria Hutchinson, BCBA
• Ideal Community Care,LLC
• Ideal Provider, LLC
• In Loving Care Home Care LLC
• Ashoka Ravi Varma Indukuri Venkata Madhava, MD
• Christopher Ingram

• Homemaker in Southaven, MS
• Providers in Southaven, MS by specialty
• Homemaker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.