Individual provider Active NPI

Laura Ross, MD

  • Diagnostic Radiology Physician
  • Jackson, TN
National Provider Identifier
1710133376
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301096158 Issued in MI
Practice address
620 Skyline Drive
Jackson, TN 38301-3923
Phone
(731) 541-6174
Fax
(616) 361-5828
NPI assigned
Aug 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 125-051180 IL
Diagnostic Radiology Physician 2085R0202X 68351 TN
Diagnostic Radiology Physician 2085R0202X 4301096158 MI Primary

Addresses

Primary practice location

620 Skyline Drive
Jackson, TN 38301-3923

Mailing address

PO Box 678210
Dallas, TX 75267-8210
Phone (616) 363-7339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100820001043 MI Practitioner - Diagnostic Radiology 6608900915 Reassigns benefits to 2 organizations
I20230418002201 TN Practitioner - Diagnostic Radiology 6608900915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kent Radiology PCGroup PAC ID 0648171850, 18 clinicians

Practice addresses (Care Compare)

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-5907

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.57 of 100Reported as group
Quality
85
Improvement activities
40
Cost
76.83

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
74.15
Promoting interoperability
77
Improvement activities
40
Cost
78.84

Merit-based Incentive Payment System (MIPS)

Final score
90.33 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

Merit-based Incentive Payment System (MIPS)

Final score
74.73 of 100Reported as group
Quality
80.7
Improvement activities
40
Cost
51.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125-051180ILMDDiagnostic Radiology Physician
68351TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kent Radiology PC Diagnostic Radiology CurrentSince Sep 26, 2024 Accepting new patients
Jackson Radiology Associates PA Diagnostic Radiology CurrentSince Jun 1, 2023 Accepting new patients
Jackson Madison County General Hospital Diagnostic Radiology CurrentSince Oct 1, 2025 Accepting new patients

Locations

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

Interoperability endpoints

  • Direct secure messaging: lross3595070@direct.trinity-health.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1710133376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678210",
            "telephone_number": "616-363-7339",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DRIVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-6174",
            "fax_number": "616-361-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125-051180",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "68351",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301096158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.