Mississippi Diversified Healthcare Inc

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

18348 Issued in MS

Legal business name

MISSISSIPPI DIVERSIFIED HEALTHCARE INC

Practice address

133 Jefferson Davis Blvd
Natchez, MS 39120-5103

Phone

(770) 443-4483

Fax

(770) 443-4410

NPI assigned

Jun 30, 2009

Last updated

Jun 30, 2009By 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

Dr. Roderick C. Givens, MDNPI 1558422576

Title

President

Phone

(601) 442-3968

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Tax ID family

Mississippi Diversified Healthcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mississippi Diversified Healthcare

  • Radiation Oncology Physician
  • Greenwood, MS
  • NPI 1407157217
  NPD tax ID

Practitioners 1

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.

• Roderick Givens, MD

  • Therapeutic Radiology Physician
  • Natchez, MS
  • NPI 1558422576
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1881822708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18394",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391228394",
            "telephone_number": "601-442-1285",
            "fax_number": "601-446-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 JEFFERSON DAVIS BLVD",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391205103",
            "telephone_number": "770-443-4483",
            "fax_number": "770-443-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI DIVERSIFIED HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "GIVENS",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-442-3968",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "MS",
            "license": "18348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miss-Lou Diagnostic Services LLC
• Miss-Lou Emergency Physicians
• Miss-Lou Gi PLLC
• Miss-Lou OB-GYN Ctr,, Inc
• Mississippi CVS Pharmacy, L.L.C. (CVS Pharmacy #05870)
• Mississippi Emergency Physician Services, LLC
• Mississippi Emergency Physician Services, LLC
• Mississippi Nephrologists LLC
• Mississippi State Department of Health (Southwest Home Health Agency)
• Mississippi State Department of Health

• Radiation Oncology Physician in Natchez, MS
• Providers in Natchez, MS by specialty
• Radiation Oncology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.