NPIMap

Organization Active NPI

Medical Imaging of Grenada Inc

  • Diagnostic Radiology Physician
  • Grenada, MS
National Provider Identifier
1659485241
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MEDICAL IMAGING OF GRENADA INC
Practice address
960 Avent Dr
Grenada, MS 38901
Phone
(601) 227-7082
Fax
(601) 227-7088
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Authorized official

Name
Dr. Arthur Bartlett Bristow, DO
Title
Owner
Phone
(601) 227-7082

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

960 Avent Dr
Grenada, MS 38901

Mailing address

PO Box 16745
Hattiesburg, MS 39404-6745
Phone (601) 227-7082

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222300800000",
    "number": "1659485241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16745",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394046745",
            "telephone_number": "601-227-7082",
            "fax_number": "601-227-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 AVENT DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "38901",
            "telephone_number": "601-227-7082",
            "fax_number": "601-227-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL IMAGING OF GRENADA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2008-09-25",
        "status": "A",
        "authorized_official_last_name": "BRISTOW",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "BARTLETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-227-7082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grenada, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.