Pulmonary Diagnostic Services LLC

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

PULMONARY DIAGNOSTIC SERVICES LLC

Practice address

114 Monument PL
Vicksburg, MS 39180-5169

Phone

(601) 636-9064

NPI assigned

Nov 12, 2012

Organization subpart

No

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

Authorized official

Name

Kristy Burke-Gullett, RRT, RPSGTNPI 1033463468

Title

Owner

Phone

(601) 218-6300

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristy Burke-Gullett, RRT, RPSGT

  • Registered Respiratory Therapist
  • Vicksburg, MS
  • NPI 1033463468
  NPD (past) Authorized official

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

{
    "created_epoch": "1352678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352678400000",
    "number": "1497099683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 DOGWOOD LAKE DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391837462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 MONUMENT PL",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805169",
            "telephone_number": "601-636-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY DIAGNOSTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-12",
        "last_updated": "2012-11-12",
        "status": "A",
        "authorized_official_last_name": "BURKE-GULLETT",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-218-6300",
        "authorized_official_credential": "RRT, RPSGT"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT REQUIRED AT THIS TIME",
            "identifier": "N/A",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Private Home Care, Inc.
• Professional Optical of Mississippi Inc
• Promise Hospital of Vicksburg Inc
• Manivanh A Prudhomme, MSN, FNP-BC, AGACNP-
• Cheryl Puckett
• Karan Puri, MD
• Purple Heart Home Care LLC
• Morgan Purvis
• Quad Intermed Company LLC
• James Michael Rainer, C.R.N.A.

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Mississippi

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