CORE NEURODIAGNOSTICS, LLC (NPI# 1043740608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043740608 |
| Entity Type | Organization |
| Organization Name | CORE NEURODIAGNOSTICS, LLC |
| Practice Address |
45 Hardy Court Ctr #230 Gulfport MS 39507-2501 |
| Practice Telephone | 2282841144 |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2017-11-17 |
| Authorized Official Name | TIMOTHY DELONG (NPI REPRESENTATIVE) |
| Authorized Official Telephone | 2105982800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers | ||
| Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
Allopathic & Osteopathic Physicians |
| Street Address |
45 HARDY COURT CTR #230 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39507-2501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285060954 | Lance Ellis Cleveland | Chiropractor | 45 Hardy Court Ctr, Ste. 103, Gulfport, MS 39507-2501 | 2013-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609389105 | Karen R Burns | Speech-Language Pathologist | 3506 Washington Avenue, Ste E, Gulfport, MS 39507 | 2017-11-07 |
| 1538605027 | Andrea Broussard | Personal Emergency Response Attendant | 406 Pass Rd, Gulfport, MS 39507 | 2017-01-09 |
| 1366872491 | William Alexis Marcia | Pharmacist | 1444 East Pass Road, Gulfport, MS 39507 | 2013-11-27 |
| 1740599380 | Advanced Hearing Systems, Inc. | Hearing Instrument Specialist | 401 Security Square, Gulfport, MS 39507 | 2010-09-30 |
| 1497068118 | Stacey Ritter Carter | Dentist | 1635 East Pass Road, Gulfport, MS 39507 | 2010-07-22 |
| 1477789964 | Letonoff Orthopaedics & Sports | Orthopaedic Surgery | 452 Court House Road, Suite G, Gulfport, MS 39507 | 2009-06-10 |
| 1730385139 | Bernard Frederick Podlin | Dentist | 400 Pass Road, Gulfport, MS 39507 | 2007-06-22 |
| 1043422553 | Mark D Stringer | Dentist | 520-a Courthouse Road, Gulfport, MS 39507 | 2007-05-04 |
| 1154543528 | Pass Road Elementary | Registered Nurse | 37 Pass Road, Gulfport, MS 39507 | 2007-05-03 |
| 1417073768 | John Hough Hopkins | Dentist | 3303 A Ave, Gulfport, MS 39507 | 2007-03-21 |
| Find all providers in zip 39507 | ||||
| Taxonomy Code | 2084N0600X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Clinical Neurophysiology |
| Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346370921 | Muscle and Nerve Pa | Psychiatry & Neurology | 971 Lakeland Drive, Suite 560, Jackson, MS 39216 | 2007-03-06 |
| 1558461459 | Michael Coleman Graeber | Psychiatry & Neurology | 971 Lakeland Dr, Suite 560 Muscle and Nerve Pa, Jackson, MS 39216-4607 | 2006-09-22 |
Please comment or provide details below to improve the information on CORE NEURODIAGNOSTICS, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.