Intervene One Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

INTERVENE ONE DIAGNOSTICS LLC

Practice address

4510 Office Park Dr
Jackson, MS 39206-6016

Phone

(662) 834-3432

NPI assigned

Jan 22, 2026

Organization subpart

No

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

Authorized official

Name

Maurice Terrell Hampton

Title

Authorized Official/Owner

Phone

(662) 834-3432

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

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": "1769040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1932058195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8586 CRAVEN RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "380029358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 OFFICE PARK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392066016",
            "telephone_number": "662-834-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENE ONE DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-22",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "HAMPTON",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_middle_name": "TERRELL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/OWNER",
        "authorized_official_telephone_number": "662-834-3432"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrative Therapeutic Counseling and Consultants
• Integrative Therapeutic Services
• Integrity Home Care Inc
• Internal Medicine Clinic of Canton, Inc
• Internal Medicine Group, P.a.
• Caroline Irby
• James W Irby Jr., PHD, ABPP-CN
• Joshua Dwight Irby, MD
• Tammy Irby
• Idiata Iredia, MD

• Clinical Medical Laboratory in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.