Rad Medical LLC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

RAD MEDICAL LLC

Practice address

103 Birdie TRL
Kosciusko, MS 39090-5106

Phone

(662) 417-5518

NPI assigned

Mar 12, 2021

Organization subpart

No

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

Authorized official

Name

James Hedgepeth

Title

Owner

Phone

(662) 417-5518

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1457936254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BIRDIE TRL",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390905106",
            "telephone_number": "662-417-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BIRDIE TRL",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390905106",
            "telephone_number": "662-417-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAD MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "HEDGEPETH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-417-5518"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Medical Group of Mississippi LLC
• Annatrice Pringle
• Pro Health Aquisition Company
• Carley J Puckett, PHARMD
• Sarah Putt, OT
• Mary Margaret Rawson, LPC, NCC
• George Robert Rea, RPH
• Joy W Reynolds, NP-C
• Elizabeth Louise Rhea
• Brady L Richardson, MD

• Mobile Radiology Clinic/Center in Kosciusko, MS
• Providers in Kosciusko, MS by specialty
• Mobile Radiology Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.