Compass Imaging LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

COMPASS IMAGING LLC

Practice address

14245 Dedeaux Rd
Gulfport, MS 39503-3369

Phone

(228) 314-7226

Fax

(228) 314-7227

NPI assigned

Jan 28, 2006

Last updated

Jan 24, 2013By 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

Ms. Leslie C Vaughn

Title

Administrator

Phone

(228) 314-7226

Specialties & licenses 1

Addresses

Other identifiers 6

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1760453799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2819",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395052819",
            "telephone_number": "228-314-7226",
            "fax_number": "228-314-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14245 DEDEAUX RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033369",
            "telephone_number": "228-314-7226",
            "fax_number": "228-314-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-28",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "228-314-7226",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10410",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16169",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR RICHARD HAYS NPI",
            "identifier": "1831232479",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR WILLAM HENRY NPI",
            "identifier": "1144363771",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR DIANNA RAGULA",
            "identifier": "1154338879",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03733573",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Physiological Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.