Active NPI
Cedar Lake Open MRI LLC
Doing business as Cedar Lake MRI
- Diagnostic Radiology Physician
- Biloxi, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- CEDAR LAKE OPEN MRI LLC
- Doing business as
- Cedar Lake MRI
- Practice address
- 1720C Medical Park Dr
Biloxi, MS 39532-2131 - Phone
- (228) 354-0251
- Fax
- (228) 396-3550
- NPI assigned
- Feb 21, 2012
- Last updated
- Jan 21, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chrystal Gary
- Title
- Director of Imaging
- Phone
- (228) 447-4674
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
1720C Medical Park Dr
Biloxi, MS 39532-2131
Mailing address
6300 E Lake Blvd Ste 301
Vancleave, MS 39565-6771
Phone (228) 354-0251
Other practice location 1
6300B E Lake Blvd
Vancleave, MS 39565-6769
Phone (228) 447-4674
Other names 1
- Cedar Lake MRI
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120910000069 | MS | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 5698747111 | Practice locations: Biloxi, MS |
| O20180815000926 | MS | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 5698747111 | Practice locations: Vancleave, MS |
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
Locations
6300 E Lake Blvd
#B
Vancleave, MS 39565
Phone (228) 447-4674
Practitioners & affiliated clinicians
Practitioners 5
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.
-
- Orthopaedic Surgery Physician
- Biloxi, MS
- NPI 1508884685
-
- Diagnostic Radiology Physician
- Gulfport, MS
- NPI 1912298498
-
- Diagnostic Radiology Physician
- Biloxi, MS
- NPI 1326275694
-
- Orthopaedic Surgery Physician
- Biloxi, MS
- NPI 1265727465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329782400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1768953600000",
"number": "1992078950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6300 E LAKE BLVD STE 301",
"city": "VANCLEAVE",
"state": "MS",
"postal_code": "395656771",
"telephone_number": "228-354-0251",
"fax_number": "228-396-3550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720C MEDICAL PARK DR",
"city": "BILOXI",
"state": "MS",
"postal_code": "395322131",
"telephone_number": "228-354-0251",
"fax_number": "228-396-3550"
}
],
"practiceLocations": [
{
"address_1": "6300B E Lake Blvd",
"address_purpose": "LOCATION",
"city": "Vancleave",
"state": "MS",
"postal_code": "395656769",
"country_code": "US",
"telephone_number": "228-447-4674",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CEDAR LAKE OPEN MRI LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-02-21",
"last_updated": "2026-01-21",
"certification_date": "2026-01-21",
"status": "A",
"authorized_official_last_name": "GARY",
"authorized_official_first_name": "CHRYSTAL",
"authorized_official_title_or_position": "DIRECTOR OF IMAGING",
"authorized_official_telephone_number": "228-447-4674"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Cedar Lake MRI",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Cedar Lake MRI",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Biloxi, MS
- Brian Wayne Caswell, CFNP
- Alkini Roycestine Catchings, KINESIOTHERAPIST
- Rene Hood Cathey, FNP
- Cedar Lake Chiropractic Inc.
- Cedar Lake Medical Center, PA
- Cedar Lake Pediatric Clinic PLLC
- Cedar Lake Pharmacy (Lee Pharmacy)
- Cedar Lake Pharmacy (Cedar Lake Pharmacy LLC.)
- Centerwell Senior Primary Care Ms CS PC
- Centerwell Senior Primary Care Ms PC (CenterWell Senior Primary Care-Biloxi)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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.