Sleep Consultants Diagnostic Lab

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

License

08416 Issued in MS

Legal business name

SLEEP CONSULTANTS DIAGNOSTIC LAB

Practice address

403 Towne Center Blvd
Ste 101a
Ridgeland, MS 39157-4843

Phone

(601) 982-7111

Fax

(601) 981-2524

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Julian F Rose, MD

Title

Owner

Phone

(601) 982-7111

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Sleep Consultants Sleep Center Doing business as

Locations

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1487856084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 TOWNE CENTER BLVD",
            "address_2": "STE 101A",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574843",
            "telephone_number": "601-982-7111",
            "fax_number": "601-981-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 TOWNE CENTER BLVD",
            "address_2": "STE 101A",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574843",
            "telephone_number": "601-982-7111",
            "fax_number": "601-981-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLEEP CONSULTANTS DIAGNOSTIC LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-982-7111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MS",
            "license": "08416",
            "primary": true
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "MS",
            "license": "08416",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "302G708148",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00010055",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sleep Consultants Sleep Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sleep Medicine (Internal Medicine) Physician in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Sleep Medicine (Internal Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.