Genetic Iq Solutions

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

GENETIC IQ SOLUTIONS

Practice address

15487 Oak LN Ste D-E
Gulfport, MS 39503-2664

Phone

(985) 685-0125

NPI assigned

Aug 28, 2024

Last updated

Aug 28, 2024By 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

Shaccase Denise JamesNPI 1679307250

Title

Director/Owner

Phone

(985) 685-0125

Specialties & licenses 1

Addresses

Locations

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.

• Shaccase Denise James

  • Clinical Medical Laboratory
  • Gulfport, MS
  • NPI 1679307250
  NPD Authorized official

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1972337335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15487 OAK LN STE D-E",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032664",
            "telephone_number": "985-685-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15487 OAK LN STE D-E",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032664",
            "telephone_number": "985-685-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENETIC IQ SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "SHACCASE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "985-685-0125"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wendy Geisel, LMSW
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• Olivia G Gennarelli, FNP
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• Barry Gentry
• Gary Dalton Gentry, APRN
• Bolos Gerges

• Clinical Medical Laboratory in Gulfport, MS
• Providers in Gulfport, 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 Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.