NPIMap

Organization Active NPI

Golden Triangle Radiology

  • Nurse Practitioner
  • Columbus, MS
National Provider Identifier
1477617272
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R590029 Issued in MS
Legal business name
GOLDEN TRIANGLE RADIOLOGY
Practice address
2003 Old Aberdeen Rd
Columbus, MS 39705-1913
Phone
(662) 328-2476
Fax
(662) 327-4605
NPI assigned
Dec 19, 2006
Last updated
Mar 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Authorized official

Name
Mrs. Alice F Naquin, C.F.N.P.
Title
Nurse Practitioner
Phone
(662) 328-2476

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X R590029 MS Primary

Addresses

Primary practice location

2003 Old Aberdeen Rd
Columbus, MS 39705-1913

Mailing address

2003 Old Aberdeen Rd
Columbus, MS 39705-1913
Phone (662) 328-2476

Other identifiers 1

IdentifierTypeStateIssuer
05283076MedicaidMS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1477617272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 OLD ABERDEEN RD",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051913",
            "telephone_number": "662-328-2476",
            "fax_number": "662-327-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 OLD ABERDEEN RD",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051913",
            "telephone_number": "662-328-2476",
            "fax_number": "662-327-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN TRIANGLE RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "NAQUIN",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "662-328-2476",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "C.F.N.P."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R590029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05283076",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.