Active NPI
Mississippi Diversified Healthcare
- Radiation Oncology Physician
- Greenwood, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- Legal business name
- MISSISSIPPI DIVERSIFIED HEALTHCARE
- Practice address
- 1401 River Rd
Greenwood, MS 38930-4030 - Phone
- (770) 443-4483
- Fax
- (770) 443-4410
- NPI assigned
- Nov 10, 2010
- 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
- Dr. Roderick C Givens, MD
- Title
- MD
- Phone
- (770) 443-4483
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | Primary |
Addresses
Primary practice location
1401 River Rd
Greenwood, MS 38930-4030
Mailing address
PO Box 18394
Natchez, MS 39122-8394
Phone (770) 443-4483
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00117509 | Medicaid | MS |
National Provider Directory
National Provider Directory- Tax ID family
- Mississippi Diversified Healthcare
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Radiation Oncology Physician
- Natchez, MS
- NPI 1881822708
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Therapeutic Radiology Physician
- Natchez, MS
- NPI 1558422576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289347200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1289347200000",
"number": "1407157217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18394",
"city": "NATCHEZ",
"state": "MS",
"postal_code": "391228394",
"telephone_number": "770-443-4483",
"fax_number": "770-443-4410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 RIVER RD",
"city": "GREENWOOD",
"state": "MS",
"postal_code": "389304030",
"telephone_number": "770-443-4483",
"fax_number": "770-443-4410"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MISSISSIPPI DIVERSIFIED HEALTHCARE",
"organizational_subpart": "NO",
"enumeration_date": "2010-11-10",
"last_updated": "2010-11-10",
"status": "A",
"authorized_official_last_name": "GIVENS",
"authorized_official_first_name": "RODERICK",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "MD",
"authorized_official_telephone_number": "770-443-4483",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Radiation Oncology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00117509",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.