Organization Active NPI

Compass Imaging LLC

  • Physiological Laboratory
  • D'Iberville, MS
National Provider Identifier
1932453065
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
COMPASS IMAGING LLC
Practice address
3200 Mallett Rd
Suite E-2
Diberville, MS 39540-9305
Phone
(228) 314-7226
NPI assigned
Oct 26, 2012
Last updated
Oct 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

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

Authorized official

Name
Leslie Vaughn
Title
Administrator
Phone
(228) 314-7226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X NU Primary

Addresses

Primary practice location

3200 Mallett Rd
Suite E-2
Diberville, MS 39540-9305

Mailing address

3200 Mallett Rd
Suite E-2
Diberville, MS 39540-9305

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2058009Compass Imaging LLC3200 Mallett Road Ste E-2, Diberville, MS 39540Certificate of waiverApr 25, 2027

National Provider Directory

National Provider Directory

Locations

3200 Mallett Rd
Ste D2
Diberville, MS 39540
Phone (228) 314-7226

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1932453065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MALLETT RD",
            "address_2": "SUITE E-2",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395409305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MALLETT RD",
            "address_2": "SUITE E-2",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395409305",
            "telephone_number": "228-314-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-26",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "228-314-7226"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in D'Iberville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.