Southern Medical Imaging

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

SOUTHERN MEDICAL IMAGING

Practice address

1 Lincoln Pkwy
Ste 300
Hattiesburg, MS 39402-3262

Phone

(601) 579-4440

Fax

(601) 579-4460

NPI assigned

Oct 3, 2006

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shelley H Gendusa

Title

Administrator

Phone

(601) 579-4453

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Cynthia D Rouse, CFNP

  • Specialist
  • Hattiesburg, MS
  • NPI 1245331859
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1568556686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LINCOLN PKWY",
            "address_2": "STE 300",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023262",
            "telephone_number": "601-579-6622",
            "fax_number": "601-579-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LINCOLN PKWY",
            "address_2": "STE 300",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023262",
            "telephone_number": "601-579-4440",
            "fax_number": "601-579-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "GENDUSA",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-579-4453"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09008521",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Laboratory Services, LLC
• Southern Medical Care
• Southern Medical Imaging
• Southern Miss Autism Research Team (Smart) Clinic
• Southern Mississippi Neonatology, PA
• Southern Neurologic & Spinal Institute
• Southern Neuroscience Center, PA
• Southern Physical Therapy, LLC

• Diagnostic Radiology Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Diagnostic Radiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.