Medical Diagnostic Services,LLC

Primary specialty

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

Legal business name

MEDICAL DIAGNOSTIC SERVICES,LLC

Doing business as

MMDS International

Practice address

2005 Venture Park
Ste 21
Kingsport, TN 37660-1098

Phone

(423) 863-0827

NPI assigned

Jun 9, 2005

Organization subpart

No

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

Authorized official

Name

Amy M Smith

Title

Vice President

Phone

(423) 863-0827

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• MMDS International Doing business as

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841294691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 VENTURE PARK",
            "address_2": "STE 21",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376601098",
            "telephone_number": "423-863-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 VENTURE PARK",
            "address_2": "STE 21",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376601098",
            "telephone_number": "423-863-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIAGNOSTIC SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "423-863-0827"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409803",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE FOR LIFE",
            "identifier": "3403932",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3403932A",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TENNESSEE",
            "identifier": "4056127",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GOLD PLUS",
            "identifier": "3403932",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMDS International",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.