IMAGING CENTER AT GLOSTER CREEK VILLAGE PLLC
NPI 1417907536
Radiology - Diagnostic Radiology in Tupelo, MS
NPI Status: Active since May 11, 2006
Contact Information
320 S GLOSTER ST
TUPELO, MS
ZIP 38801
Phone: (662) 841-7880
Fax: (662) 821-1888
- Organization
- Radiology
- Diagnostic Radiology
- Accepts Insurance
- CLIA Number: 25D1014379
- CLIA Cert. Type: Other - FREE STANDING DIAG RAD CL
- CLIA Exp. Date: 10-26-2026
About IMAGING CENTER AT GLOSTER CREEK VILLAGE PLLC
This page provides the complete NPI Profile along with additional information for Imaging Center At Gloster Creek Village Pllc, a provider established in Tupelo, Mississippi operating as a Radiology, focusing in diagnostic radiology . The healthcare provider is registered in the NPI registry with number 1417907536 assigned on May 2006. The practitioner's primary taxonomy code is 2085R0202X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Daniel Schaefer (Coo)
- NPI
- 1417907536
- Provider Name
- IMAGING CENTER AT GLOSTER CREEK VILLAGE PLLC
- Entity Type
- Organization
- Location Address
- 320 S GLOSTER ST TUPELO, MS 38801
- Location Phone
- (662) 841-7880
- Location Fax
- (662) 821-1888
- Mailing Address
- 320 S GLOSTER ST TUPELO, MS 38801
- Mailing Phone
- (662) 841-7880
- Mailing Fax
- (662) 821-1888
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-11-2006
- Last Update Date
- 07-21-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Radiology Diagnostic Radiology
- Taxonomy Code
- 2085R0202X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue HSA Bronze - PPO
- Blue Protect - PPO
- Blue Saver Bronze - PPO
- Blue Standardized Statewide Silver EPO - EPO
- Blue Statewide Silver EPO - EPO
- Blue Value Gold - PPO
- Blue Value Silver - PPO
- Blue Access Gold for Business - PPO
- Blue Choice Platinum for Business - PPO
- Blue HSA Silver for Business - PPO
- Molina Gold Standard - HMO
- Molina Silver Standard - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| DA0120 | OTHER (01) | MEDICARE RAILROAD | |
| 09016308 | MEDICAID (05) | MS | |
| 123156800 | OTHER (01) | DEPT OF LABOR # |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 25D1014379
- Facility Type
- Other - FREE STANDING DIAG RAD CL
- Certificate Effective Date
- October 27, 2024
- Certificate Expiration Date
- October 26, 2026
- Laboratory Director
- WILLIAM C. HENSON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Imaging Center At Gloster Creek Village Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1417907536, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
TUPELO, MS 38801
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417907536, enumerated as an "organization" on May 11, 2006.
The provider is located at 320 S GLOSTER ST TUPELO, MS 38801 and the phone number is (662) 841-7880.
Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Alabama, Molina. Please consult your insurance carrier or call the provider to verify.
