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MID DELTA RADIOLOGY ASSOCIATES, LLC
NPI 1487904173
Radiology - Diagnostic Radiology in Clarksdale, MS

Active since September 11, 2012
130 RIVER CLUB CIR, CLARKSDALE, MS 38614(662) 832-3514(866) 782-0773 Get Directions Write a Review

NPPES record last updated: July 5, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mid Delta Radiology Associates, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MID DELTA RADIOLOGY ASSOCIATES, LLC (NPI 1487904173) is a healthcare organization registered as a diagnostic radiology in Clarksdale, Mississippi and active in the NPI registry since September 2012. The organization lists Kelley Oliver, Manager, as its authorized official.

NPPES Registry Identity

NPI1487904173
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameMID DELTA RADIOLOGY ASSOCIATES, LLC
Location Address130 RIVER CLUB CIRClarksdale, MS 38614-9725
Mailing Address130 River Club CirClarksdale, MS 38614-9725 · (662) 832-3514 · Fax (866) 782-0773
Phone(662) 832-3514
Fax(866) 782-0773
Organization SubpartNo
Authorized OfficialKelley OliverManager · (662) 832-3514
Enumeration DateSeptember 11, 2012
Last NPPES UpdateJuly 5, 2023
NPPES CertifiedJuly 5, 2023
✔ NPI 1487904173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in AR · E7789
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
130 RIVER CLUB CIR, Clarksdale, MS 38614
Open in Google Maps ↗

Other Identifiers 1

Medicaid209761002AR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mid Delta Radiology Associates, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Mid Delta Radiology Associates, LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

John Oliver, M.D.
Diagnostic Radiology
NPI 1073775466
1801 MARTIN LUTHER KING JR DR
Helena, AR 72342
(662) 588-9914
✔ PECOS✔ Accepts Medicare20 mi
Joseph Oliver, M.D.
Diagnostic Radiology
NPI 1699798306
2500 N STATE ST
Jackson, MS 39216
(601) 984-2538
✔ PECOS✔ Accepts Medicare133 mi

Source: 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 Mid Delta Radiology Associates, LLC's NPI number?

The NPI number for Mid Delta Radiology Associates, LLC is 1487904173. It was assigned to this organization in the NPPES registry on September 11, 2012.

Where is Mid Delta Radiology Associates, LLC located?

Mid Delta Radiology Associates, LLC is located at 130 River Club Cir, Clarksdale, MS 38614. The listed phone number is (662) 832-3514.

What is Mid Delta Radiology Associates, LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Mid Delta Radiology Associates, LLC enrolled in Medicare?

Yes. Mid Delta Radiology Associates, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mid Delta Radiology Associates, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Diagnostic Radiology, reassign their Medicare billing to Mid Delta Radiology Associates, LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mid Delta Radiology Associates, LLC was last updated on July 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.