NPIMap

Organization Active NPI

Meridian Imaging, PA

  • Diagnostic Radiology Physician
  • Meridian, MS
National Provider Identifier
1962682468
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MERIDIAN IMAGING, PA
Practice address
1102 Constitution Ave
First Floor
Meridian, MS 39301-4001
Phone
(601) 693-5843
Fax
(601) 693-0173
NPI assigned
Nov 13, 2007
Last updated
Jun 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Authorized official

Name
Dr. Michael Stacy Thaggard, M.D.NPI 1659352011
Title
President
Phone
(601) 693-5843

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary
Vascular & Interventional Radiology Physician 2085R0204X NU

Addresses

Primary practice location

1102 Constitution Ave
First Floor
Meridian, MS 39301-4001

Mailing address

PO Box 5653
Meridian, MS 39302-5653
Phone (601) 693-5843

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080326000216 MS Part B Supplier - Clinic/Group Practice 9234215625 Receives reassigned benefits from 5 practitioners
Practice locations: Meridian, MS

National Provider Directory

National Provider Directory

Locations

1102 Constitution Ave
Fl 1
Meridian, MS 39301
Phone (601) 693-5843

1102 Constitution Ave
Fl First
Meridian, MS 39301
Phone (601) 693-5843

Practitioners & affiliated clinicians

Practitioners 9

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": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1962682468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5653",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025653",
            "telephone_number": "601-693-5843",
            "fax_number": "601-693-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CONSTITUTION AVE",
            "address_2": "FIRST FLOOR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014001",
            "telephone_number": "601-693-5843",
            "fax_number": "601-693-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN IMAGING, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "THAGGARD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "STACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-693-5843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.