IMAGING CENTER AT GLOSTER CREEK VILLAGE PLLC
NPI 1417907536
Radiology - Diagnostic Radiology in Tupelo, MS
About Imaging Center At Gloster Creek Village Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IMAGING CENTER AT GLOSTER CREEK VILLAGE PLLC (NPI 1417907536) is a healthcare organization registered as a diagnostic radiology in Tupelo, Mississippi and active in the NPI registry since May 2006. The organization lists Daniel Schaefer, Coo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Imaging Center At Gloster Creek Village Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
24Medicare enrollment records show 24 clinicians reassign Medicare billing to Imaging Center At Gloster Creek Village PLLC, which bills Medicare for the services they deliver. Of these, 9 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 2
Nearest to this location (20)
See all 24Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Imaging Center At Gloster Creek Village PLLC's NPI number?
The NPI number for Imaging Center At Gloster Creek Village PLLC is 1417907536. It was assigned to this organization in the NPPES registry on May 11, 2006.
Where is Imaging Center At Gloster Creek Village PLLC located?
Imaging Center At Gloster Creek Village PLLC is located at 320 S Gloster St, Tupelo, MS 38801. The listed phone number is (662) 841-7880.
What is Imaging Center At Gloster Creek Village PLLC's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.
Is Imaging Center At Gloster Creek Village PLLC enrolled in Medicare?
Yes. Imaging Center At Gloster Creek Village PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Imaging Center At Gloster Creek Village PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 24 clinicians in 2 Medicare specialties reassign their Medicare billing to Imaging Center At Gloster Creek Village PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (22) and Interventional Radiology (2). Of these, 9 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Imaging Center At Gloster Creek Village PLLC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Imaging Center At Gloster Creek Village PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Imaging Center At Gloster Creek Village PLLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Imaging Center At Gloster Creek Village Pllc · NPI 1417907536
Diagnostic Radiology organization in Tupelo, Mississippi. Organization record, active in the CMS NPPES registry since May 11, 2006.
## Identity
- **NPI:** 1417907536 (Entity type: Organization)
- **Enumerated:** May 11, 2006
- **Primary specialty:** Radiology - Diagnostic Radiology · taxonomy 2085R0202X
- **Organization subpart:** No
- **Authorized official:** Daniel Schaefer, COO
## Practice location
- **Address:** 320 S GLOSTER ST, Tupelo, MS 38801-4748
- **Phone:** (662) 841-7880 · **Fax:** (662) 821-1888
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 24 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (22), Interventional Radiology (2); 9 practice within 10 miles; [full list](https://npiprofile.com/npi/1417907536/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 21, 2022
- **Other identifiers:** Other DA0120; Medicaid 09016308 (MS); Other 123156800
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Source: [NPI Profile](https://npiprofile.com/npi/1417907536) · Data from the CMS NPPES public registry.