Organization Active NPI

Gci Radiology PLLC

  • Diagnostic Radiology Physician
  • Biloxi, MS
National Provider Identifier
1407364482
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
GCI RADIOLOGY PLLC
Practice address
150 Reynoir St
Biloxi, MS 39530
Phone
(228) 432-1571
NPI assigned
Jan 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Authorized official

Name
Dr. Jason B. Crowder, MDNPI 1114988086
Title
Partner/Co-Owner
Phone
(228) 731-7114

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X MS Primary

Addresses

Primary practice location

150 Reynoir St
Biloxi, MS 39530

Mailing address

PO Box 3488
Tupelo, MS 38803-3488
Phone (228) 731-7114

Other practice location 1

14257 Dedeaux Rd
Gulfport, MS 39503-3369
Phone (228) 314-7226

Other practice location 2

3200 Mallett Rd Ste E2
Diberville, MS 39540-9305
Phone (228) 314-7226

Other practice location 3

14245 Dedeaux Rd
Gulfport, MS 39503-3369
Phone (228) 314-7226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180406000066 MS Part B Supplier - Clinic/Group Practice 4284997107 Receives reassigned benefits from 10 practitioners
Practice locations: Biloxi, MS; Diberville, MS; Gulfport, MS

National Provider Directory

National Provider Directory

Locations

14257 Dedeaux Rd
Gulfport, MS 39503
Phone (228) 314-7226

Practitioners & affiliated clinicians

Practitioners 11

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": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528156800000",
    "number": "1407364482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3488",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033488",
            "telephone_number": "228-731-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 REYNOIR ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39530",
            "telephone_number": "228-432-1571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14257 Dedeaux Rd",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395033369",
            "country_code": "US",
            "telephone_number": "228-314-7226",
            "fax_number": "228-314-7227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 Mallett Rd Ste E2",
            "address_purpose": "LOCATION",
            "city": "Diberville",
            "state": "MS",
            "postal_code": "395409305",
            "country_code": "US",
            "telephone_number": "228-314-7226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14245 Dedeaux Rd",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395033369",
            "country_code": "US",
            "telephone_number": "228-314-7226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GCI RADIOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-06-05",
        "status": "A",
        "authorized_official_last_name": "CROWDER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PARTNER/CO-OWNER",
        "authorized_official_telephone_number": "228-731-7114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; 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.