AMERICAN SLEEP DIAGNOSTICS LLC
Complete NPI Record 1396779567
Clinical Medical Laboratory in Long Beach, MS

Active since July 11, 2006
106 WILLOW CREEK DR, LONG BEACH, MS 39560(228) 865-3998(228) 865-1665 Get Directions

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Complete NPI Dataset

This page contains the complete raw NPPES record for American Sleep Diagnostics Llc (NPI 1396779567), a clinical medical laboratory organization in Long Beach, MS. All 34 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

Registry File Document Utilities
NPI: 1396779567
Field 1/34
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Field 2/34
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: Not available
Field 3/34
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: AMERICAN SLEEP DIAGNOSTICS LLC
Field 4/34
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: PO BOX 660
Field 5/34
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: LONG BEACH
Field 6/34
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MS
Field 7/34
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 395600660
Field 8/34
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
Field 9/34
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 2288653998
Field 10/34
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 2288651665
Field 11/34
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 106 WILLOW CREEK DR
Field 12/34
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: LONG BEACH
Field 13/34
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MS
Field 14/34
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 395603311
Field 15/34
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
Field 16/34
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 2288653998
Field 17/34
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 2288651665
Field 18/34
The fax number associated with the location address of the provider being identified.
Authorized Official Last Name: GRAVES
Field 21/34
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: LAWRENCE
Field 22/34
The first name of the authorized official.
Authorized Official Middle Name: JASPER
Field 23/34
The middle name of the authorized official.
Authorized Official Title or Position: MANAGING PARTNER
Field 24/34
The title or position of the authorized official.
Authorized Official Telephone Number: 2288971636
Field 25/34
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 291U00000X
Field 26/34
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 1: MS
Field 27/34
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 1: Y
Field 28/34
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Other Provider Identifier 1: 0125706
Field 29/34
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 1: 05
Field 30/34
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 1: MS
Field 31/34
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Is Organization Subpart: N
Field 32/34
Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Authorized Official Name Prefix Text: DR.
Field 33/34
The prefix used in the name of the authorized official associated with the provider's NPI record. Examples include Mr., Ms., Mrs., Dr., or other common professional or personal prefixes.
Authorized Official Credential Text: DDS
Field 34/34
The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.
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