Mobile Heart Station Inc

Primary specialty

Vascular Specialist/Technologist CardiovascularTaxonomy code 246XC2903X

License

ARDMS11532

Legal business name

MOBILE HEART STATION INC

Practice address

196 Timberlane Road
Picayune, MS 39466

Phone

(601) 799-5169

Fax

(601) 799-3998

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. War T Vichayanond, PHD FASE RDCS

Title

President & Ceo

Phone

(601) 799-5169

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Mobile CV 2000 Inc Former legal business name

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288656000000",
    "number": "1356428569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 TIMBERLANE ROAD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "39466",
            "telephone_number": "601-799-5169",
            "fax_number": "601-799-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 TIMBERLANE ROAD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "39466",
            "telephone_number": "601-799-5169",
            "fax_number": "601-799-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE HEART STATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-11-02",
        "status": "A",
        "authorized_official_last_name": "VICHAYANOND",
        "authorized_official_first_name": "WAR",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "601-799-5169",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD FASE RDCS"
    },
    "taxonomies": [
        {
            "code": "246XC2903X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist Cardiovascular, Vascular Specialist",
            "state": null,
            "license": "ARDMS11532",
            "primary": true
        },
        {
            "code": "246XS1301X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist Cardiovascular, Sonography",
            "state": null,
            "license": "ARDMS11532",
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": null,
            "license": "ARDMS",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "470000422",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117333",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OF LA",
            "identifier": "5CB82",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile CV 2000 Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Mississippi Medical Research, LLC
• Heather Mitchell
• Megan Alyse Mitchell, NP
• Michael Byron Mitchell, MD
• Kristie Michelle Mixon
• Heidi Dryden Molaison, OTR/L
• Breanna Delores Moore
• Tanyel Torrell Moran, PHARMACIST
• Carol A Morreale, PHARMD, BCPS, CGP
• Mpower Healing, PLLC

• Vascular Specialist/Technologist Cardiovascular in Picayune, MS
• Providers in Picayune, MS by specialty
• Vascular Specialist/Technologist Cardiovascular in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.