PORTABLE MEDICAL DIAGNOSTICS LLC NPI 1174804355

NPI Information

  • NPI: 1174804355
  • Provider Name: PORTABLE MEDICAL DIAGNOSTICS LLC
  • Classification: Clinic/Center - 261QR0208X
  • Specialization: Radiology, Mobile
  • Entity Type: Organization
  • Address: 1855 LAKELAND DR
    STE G10
    JACKSON, MS
    ZIP 39216
  • Phone: (601) 987-9729

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NPI Details

PORTABLE MEDICAL DIAGNOSTICS LLC is a radiology and mobile clinic center in Jackson, MS. PORTABLE MEDICAL DIAGNOSTICS LLC NPI is 1174804355. The provider is registered as an organization entity type.

The provider's business location address is:

1855 LAKELAND DR
STE G10
JACKSON, MS
ZIP 39216-926
Phone: (601) 987-9729
Fax: (601) 987-0093

The provider's authorized official is Douglas Brown .
The authorized official title is Managing Partner and has the following contact phone number (601) 260-6008.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • Ultrasound of leg arteries or artery grafts (HCPCS:93925)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • Ultrasound study of arm and leg arteries (HCPCS:93922)
  • Ultrasound of one leg arteries or artery grafts (HCPCS:93926)
  • Complete ultrasound scan behind abdominal cavity (HCPCS:76770)
  • Complete ultrasound scan of abdomen (HCPCS:76700)
  • Limited ultrasound scan of abdomen (HCPCS:76705)
  • Ultrasound scan of head and neck soft tissue (HCPCS:76536)
  • Complete ultrasound scan of pelvis (HCPCS:76856)
  • Ultrasound of one arm arteries or artery grafts (HCPCS:93931)

The enumeration date for this NPI number is 9/1/2011 and was last updated on 5/15/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0208XClinic/CenterRadiology, MobileMISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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