Active NPI
Charles Alumbaugh
- Computed Tomography Radiologic Technologist
- Petal, MS
National Provider Identifier
1922497387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Computed Tomography Radiologic Technologist
- License
- MRT1712
- Practice address
- 9 Lake Loop
Petal, MS 39465-9002 - Phone
- (601) 549-4714
- NPI assigned
- Jan 22, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | MRT1712 | MS | |
| Computed Tomography Radiologic Technologist | 2471C3401X | MRT1712 | MS | Primary |
Addresses
Primary practice location
9 Lake Loop
Petal, MS 39465-9002
Mailing address
9 Lake Loop
Petal, MS 39465-9002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MRT1712 | MS | MD | Computed Tomography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421884800000",
"number": "1922497387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 LAKE LOOP",
"city": "PETAL",
"state": "MS",
"postal_code": "394659002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 LAKE LOOP",
"city": "PETAL",
"state": "MS",
"postal_code": "394659002",
"telephone_number": "601-549-4714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALUMBAUGH",
"first_name": "CHARLES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-22",
"last_updated": "2015-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "MS",
"license": "MRT1712",
"primary": false
},
{
"code": "2471C3401X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Computed Tomography",
"state": "MS",
"license": "MRT1712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petal, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.