Gulf Coast Mobile Imaging

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

GULF COAST MOBILE IMAGING

Practice address

7020 Highway 190 Ste a
Covington, LA 70433-4962

Phone

(337) 594-9637

NPI assigned

Jan 22, 2007

Last updated

Jun 17, 2022By 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

Mrs. Deanna Faselt, VICE PRESIDENT

Title

Owner

Phone

(702) 839-1133

Specialties & licenses 2

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, and the practitioner matching its NPPES authorized official.

• Calvin Dale Vidrine, CRA RJ RN

  • Diagnostic Radiology Physician
  • Opelousas, LA
  • NPI 1639122195
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655424000000",
    "number": "1659425544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 PROFESSIONAL CT STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280835",
            "telephone_number": "702-839-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7020 HIGHWAY 190 STE A",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704334962",
            "telephone_number": "337-594-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST MOBILE IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A",
        "authorized_official_last_name": "FASELT",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-839-1133",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "VICE PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist",
            "state": "LA",
            "license": "088168",
            "primary": false
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2100041",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dorand Guillory, APRN
• Jacques L Guillot, MD
• Claude Arthur Guillotte, LPC
• Gulf Coast Brain Sport & Spine LLC
• Gulf Coast Children's Speech Services, LLC
• Gulf Coast Wound Care LLC
• Gulf South Medical & Surgical Institute, Inc. (Covington Dermatology Clinic)
• Gulfsouth Critical Care LLC
• Gulfsouth Hospital Medicine LLC
• Gulfsouth Neurology LLC

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Covington, LA
• Providers in Covington, LA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.