Organization Active NPI

American Sleep Diagnostics LLC

  • Clinical Medical Laboratory
  • Long Beach, MS
National Provider Identifier
1396779567
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
AMERICAN SLEEP DIAGNOSTICS LLC
Practice address
106 Willow Creek Dr
Long Beach, MS 39560-3311
Phone
(228) 865-3998
Fax
(228) 865-1665
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lawrence Jasper Graves, DDS
Title
Managing Partner
Phone
(228) 897-1636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X MS Primary

Addresses

Primary practice location

106 Willow Creek Dr
Long Beach, MS 39560-3311

Mailing address

PO Box 660
Long Beach, MS 39560-0660
Phone (228) 865-3998

Other identifiers 1

IdentifierTypeStateIssuer
0125706MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100406000226 MS Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6608902390 Practice locations: Long Beach, MS
O20130918000255 MS Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6608902390 Practice locations: Biloxi, MS

National Provider Directory

National Provider Directory

Locations

993 Tommy Munro Dr
Ste B
Biloxi, MS 39532
Phone (228) 385-5550

106 Willow Creek Dr
Long Beach, MS 39560
Phone (228) 865-3998

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396779567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395600660",
            "telephone_number": "228-865-3998",
            "fax_number": "228-865-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WILLOW CREEK DR",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395603311",
            "telephone_number": "228-865-3998",
            "fax_number": "228-865-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN SLEEP DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "JASPER",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "228-897-1636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125706",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.

Verify at the official NPI Registry.