Organization Active NPI

Radiology Associates of Oxford - PA

  • Diagnostic Radiology Physician
  • Oxford, MS
National Provider Identifier
1750337143
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY ASSOCIATES OF OXFORD - PA
Practice address
2301 S Lamar Blvd
Oxford, MS 38655-5373
Phone
(662) 232-8100
Fax
(901) 753-2896
NPI assigned
May 26, 2006
Last updated
Dec 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Authorized official

Name
Stuart Todd RothNPI 1053350678
Title
MD
Phone
(662) 232-8158

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

2301 S Lamar Blvd
Oxford, MS 38655-5373

Mailing address

791 Walnut Knoll LN
2ND FL
Cordova, TN 38018-8839
Phone (901) 755-7001

Other identifiers 1

IdentifierTypeStateIssuer
00115759MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, GA, DC, FL, IL, LA, AR, VA, CA, PA, NV11 enrollments

Enrollment records 11

Enrollment IDStateProvider typePAC IDDetails
O20040504001029 MS Part B Supplier - Clinic/Group Practice 1052309424 Receives reassigned benefits from 10 practitioners
Practice locations: Batesville, MS; Marks, MS; Oxford, MS
O20211102000545 GA Part B Supplier - Clinic/Group Practice 1052309424 Receives reassigned benefits from 4 practitioners
Practice locations: Atlanta, GA; Smyrna, GA; Woodstock, GA
O20211102001025 DC Part B Supplier - Clinic/Group Practice 1052309424 Receives reassigned benefits from 1 practitioner
Practice locations: Potomac, MD
O20211102002918 FL Part B Supplier - Clinic/Group Practice 1052309424 Receives reassigned benefits from 1 practitioner
Practice locations: Melbourne, FL
O20211103001177 IL Part B Supplier - Clinic/Group Practice 1052309424 Receives reassigned benefits from 2 practitioners
Practice locations: South Barrington, IL; Villa Park, IL
O20211103002162 LA Part B Supplier - Clinic/Group Practice 1052309424 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, LA
O20211103002362 AR Part B Supplier - Clinic/Group Practice 1052309424 Receives reassigned benefits from 1 practitioner
Practice locations: Little Rock, AR
O20211104003103 VA Part B Supplier - Clinic/Group Practice 1052309424 Receives reassigned benefits from 1 practitioner
Practice locations: Roanoke, VA
O20211108001180 CA Part B Supplier - Clinic/Group Practice 1052309424 Receives reassigned benefits from 4 practitioners
Practice locations: Glendale, CA; Santa Monica, CA; Newport Beach, CA; Piedmont, CA
O20240208002967 PA Part B Supplier - Clinic/Group Practice 1052309424 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenixville, PA
O20240802002820 NV Part B Supplier - Clinic/Group Practice 1052309424 Receives reassigned benefits from 1 practitioner
Practice locations: Reno, NV

National Provider Directory

National Provider Directory

Locations

1202 Office Park Dr
Ste B
Oxford, MS 38655
Phone (662) 234-5545

791 Walnut Knoll Ln
Ste 2
Cordova, TN 38018
Phone (800) 274-7777

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1750337143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 WALNUT KNOLL LN",
            "address_2": "2ND FL",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380188839",
            "telephone_number": "901-755-7001",
            "fax_number": "901-753-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555373",
            "telephone_number": "662-232-8100",
            "fax_number": "901-753-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF OXFORD - PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "662-232-8158"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115759",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.