Proteus Genomics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PROTEUS GENOMICS, LLC

Practice address

6766 U S Highway 98 Ste 1B
Hattiesburg, MS 39402-8443

Phone

(601) 549-4182

NPI assigned

Jul 30, 2022

Organization subpart

Yes

Parent organization

PROTEUS MOLECULAR AND CLINICAL LAB LLCAs reported in NPPES

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

Authorized official

Name

Michael Griffith

Title

Member/Manager

Phone

(205) 478-7302

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Part of

Proteus Molecular CLN Lab

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Proteus Molecular and Clinical Lab LLC

  • Clinical Medical Laboratory
  • Homewood, AL
  • NPI 1538542196

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1659139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659139200000",
    "number": "1558097592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6766 U S HIGHWAY 98 STE 1B",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6766 U S HIGHWAY 98 STE 1B",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028443",
            "telephone_number": "601-549-4182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTEUS GENOMICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROTEUS MOLECULAR AND CLINICAL LAB LLC",
        "enumeration_date": "2022-07-30",
        "last_updated": "2022-07-30",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "205-478-7302"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila R Priestley, LMSW
• Holly Womack Primeaux, M.D.
• Rebecca Kathryn Privon, FNP-C
• Promptcare Home Infusion, LLC
• William S Prosser, DPT
• Providence Behavioral Health Services
• Providence Hospice South, LLC
• PRX LLC
• PRX LLC
• Devon Pryne

• Clinical Medical Laboratory in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2022; 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.