DR. LAURA ROSS MD
NPI 1710133376
Radiology - Diagnostic Radiology in Jackson, TN

Q: What is Laura Ross's NPI number?

The NPI number for Laura Ross is 1710133376. It was assigned to this individual provider in the NPPES registry on August 14, 2008.

Q: What is Laura Ross's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Laura Ross was last updated on August 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since August 14, 2008PECOS EnrolledAccepts Medicare Assignment

84.05/100

CMS Quality Rating

620 SKYLINE DRIVE, JACKSON, TN 38301(731) 541-6174(616) 361-5828 Get Directions Write a Review

NPPES record last updated: August 23, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Laura Ross Md NPPES

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

DR. LAURA ROSS MD (NPI 1710133376) is an individual diagnostic radiology provider in Jackson, Tennessee, licensed in Michigan (4301096158) and active in the NPI registry since August 2008. She is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of New York Medical College (2005).

NPPES Registry Identity

NPI1710133376

Entity TypeIndividualFemale

Primary Taxonomy2085R0202X

Provider Legal NameDR. LAURA ROSSCredential: MD

Location Address620 SKYLINE DRIVEJackson, TN 38301-3923

Mailing AddressPo Box 678210Dallas, TX 75267-8210 · (616) 363-7339 · Fax (616) 361-5828

Phone(731) 541-6174

Fax(616) 361-5828

Sole ProprietorNo

Medical School CMSNew York Medical CollegeGraduated 2005

Enumeration DateAugust 14, 2008

Last NPPES UpdateAugust 23, 2024

✔ NPI 1710133376 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

Licenses✔ Licensed in MI · 4301096158✔ Licensed in IL · 125-051180✔ Licensed in TN · 68351

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

620 SKYLINE DRIVE, Jackson, TN 38301

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Laura Ross Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608900915

PECOS Enrollment IDI20100820001043

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Laura Ross reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Jackson Madison County General Hospital

Same address

Diagnostic Radiology

620 SKYLINE DR
Jackson, TN 38301

Reassigned Medicare billing, Tennessee enrollment
22 clinicians in this Medicare group

NPI 1891687208 (731) 541-5000

Jackson Radiology Associates PA

3.0 mi

Diagnostic Radiology

31 SANDSTONE CIR
Jackson, TN 38305

Reassigned Medicare billing, Michigan and Tennessee enrollments
4 clinicians in this Medicare group

NPI 1699700716 (731) 240-1747

Kent Radiology PC

533 mi

Diagnostic Radiology

200 JEFFERSON AVE SE
Grand Rapids, MI 49503

Reassigned Medicare billing, Michigan enrollment
18 clinicians in this Medicare group

NPI 1760416960 (616) 364-6700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 68

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of chest, 1 view 71045

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

412 services380 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

383 services367 patients

Screening mammography 77067

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

302 services302 patients

Screening 3d breast mammography 77063

Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.

256 services256 patients

Screening mammography 77067

153 services153 patients

Screening 3d breast mammography 77063

134 services134 patients

Nuclear medicine study from skull base to mid-thigh with ct scan 78815

A nuclear medicine study from skull base to mid-thigh with a CT scan involves using a small amount of radioactive material and CT imaging to examine body tissues and organs. This helps detect any abnormalities by providing detailed images of the body's internal structure.

117 services116 patients

Ct scan head or brain without contrast 70450

A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.

113 services113 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

111 services107 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

103 services103 patients

Ct scan of abdomen and pelvis with contrast 74177

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

88 services88 patients

Limited ultrasound scan of abdomen 76705

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

86 services86 patients

X-ray of abdomen, 1 view 74018

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

81 services74 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

69 services69 patients

X-ray of foot, 2 views 73620

An X-ray of the foot, 2 views, is a quick, painless test that produces images of the bones and structures inside your foot. Two different angles are used to provide a comprehensive view. This helps doctors diagnose fractures, infections, or other abnormalities.

68 services60 patients

X-ray of abdomen, 1 view 74018

65 services64 patients

X-ray of chest, 2 views 71046

49 services47 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

45 services45 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

43 services42 patients

Ct scan of chest with contrast 71260

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

42 services42 patients

Complete ultrasound scan behind abdominal cavity 76770

41 services41 patients

Complete ultrasound scan of abdomen 76700

A complete ultrasound scan of the abdomen is a non-invasive imaging procedure. It uses sound waves to produce images of the organs in your abdomen, such as the liver, gallbladder, spleen, pancreas, and kidneys. It helps in diagnosing, monitoring, and planning treatments.

40 services40 patients

Ct scan of abdomen and pelvis without contrast 74176

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

39 services39 patients

Limited ultrasound scan of abdomen 76705

38 services38 patients

Mri scan of abdomen before and after contrast 74183

An MRI scan of the abdomen before and after contrast provides detailed images of your abdominal organs. Initially, images are taken without a contrast agent. Then, a safe dye is administered, usually via an IV, to highlight certain areas, giving a clearer picture to help diagnose various conditions.

36 services36 patients

Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) G0279

Diagnostic digital breast tomosynthesis is a 3D imaging test that allows doctors to examine your breast tissue layer by layer. It's performed on one or both sides. It helps in detecting abnormalities more accurately. It's often done in addition to other tests.

36 services36 patients

Ct scan of chest without contrast 71250

34 services34 patients

Ct scan of abdomen and pelvis without contrast 74176

34 services34 patients

Ct scan of upper spine without contrast 72125

A CT scan of the upper spine without contrast is a non-invasive imaging test that uses X-rays to capture detailed images of your neck and upper back. It helps in identifying issues like fractures, tumors, or infections. No dye (contrast) is used in this scan.

33 services33 patients

Ct scan of abdomen and pelvis with contrast 74177

33 services33 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

33 services32 patients

Ct scan of blood vessels of chest with contrast 71275

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

30 services30 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

30 services30 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

30 services30 patients

Complete ultrasound scan of abdomen 76700

28 services28 patients

Diagnostic mammography of 1 breast 77065

Diagnostic mammography of 1 breast is a detailed imaging test that allows doctors to closely examine a specific area in the breast. It's often used when a routine screening reveals an abnormality. This test can help identify any unusual changes or issues.

27 services27 patients

Nuclear medicine study of bone and/or joint whole body 78306

A nuclear medicine study of bone and/or joint whole body involves injecting a small amount of radioactive material into your body. This material travels to your bones and emits energy. A special camera captures this energy, creating images of your bones to help identify any abnormalities.

26 services26 patients

Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) G0279

25 services25 patients

Diagnostic mammography of 1 breast 77065

24 services23 patients

Ct scan of blood vessels of neck with contrast 70498

A CT scan of the neck's blood vessels with contrast is a diagnostic procedure. It uses X-rays and a special dye to create detailed images of your neck's blood vessels. This helps doctors detect issues such as blockages or abnormalities.

23 services23 patients

X-ray of hip, 2-3 views 73502

23 services22 patients

Ct scan of blood vessels of head with contrast 70496

A CT scan of the head's blood vessels with contrast is a diagnostic procedure. A special dye (contrast) is injected into your body to make the blood vessels visible on the scan. This helps identify issues like blockages or abnormalities in your head's blood vessels.

22 services22 patients

Low dose ct scan of chest for lung cancer screening 71271

A low-dose CT scan of the chest is a quick, painless procedure that uses a small amount of radiation to create detailed images of your lungs. It's a key tool for early detection of lung cancer, especially for those at high risk.

21 services21 patients

X-ray of shoulder, 1 view 73020

An X-ray of the shoulder, 1 view, is a quick, painless test that produces images of the bones and tissues within your shoulder. It helps diagnose conditions such as fractures, infections, or arthritis. You'll be positioned to capture the best view, then a small dose of radiation creates the image.

21 services21 patients

Ultrasound scan of head and neck soft tissue 76536

21 services21 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

20 services17 patients

Nuclear medicine study limited area with ct scan 78814

A nuclear medicine study with a limited area CT scan is a diagnostic procedure. A small amount of radioactive substance is injected into your body, which helps create detailed images of a specific area. The CT scan further enhances these images, providing clearer, more precise results.

20 services20 patients

X-ray of lower and sacral spine, 2-3 views 72100

19 services19 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

19 services18 patients

Limited ultrasound scan of 1 breast 76642

A limited ultrasound scan of one breast is a non-invasive imaging test. It uses sound waves to create pictures of the inside of your breast. It helps identify any unusual growths or changes. It's safe, quick, and typically painless.

19 services19 patients

Ct scan head or brain without contrast 70450

18 services18 patients

Diagnostic mammography of both breasts 77066

Diagnostic mammography involves using special imaging technology to capture detailed images of both breasts. This procedure helps in identifying any unusual changes or abnormalities. It's a crucial step in ensuring breast health and early detection of potential issues.

18 services18 patients

X-ray of paranasal sinus, 1-2 views 70210

An X-ray of the paranasal sinus is a safe, quick imaging procedure. It uses a small amount of radiation to create images of the sinus cavities in your face. This helps doctors diagnose conditions such as sinusitis or other sinus problems. The 1-2 views mean images from one or two different angles will be taken.

17 services16 patients

Low dose ct scan of chest for lung cancer screening 71271

17 services17 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

17 services15 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

17 services17 patients

X-ray of knee, 1-2 views 73560

15 services12 patients

Nuclear medicine study of liver and bile duct system 78226

A nuclear medicine study of the liver and bile duct system involves the use of a small amount of radioactive material to create detailed images. This helps doctors examine the liver's function and structure, and detect any abnormalities in the bile ducts.

15 services15 patients

Ultrasound study of arm or leg veins with compression and maneuvers 93970

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

15 services15 patients

Mri scan of brain without contrast 70551

An MRI scan of the brain without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your brain. It helps in detecting abnormalities like tumors, stroke, inflammation, or infection.

14 services14 patients

Ct scan of chest with contrast 71260

14 services14 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

14 services14 patients

X-ray of middle spine, 3 views 72072

An X-ray of the middle spine, with 3 views, is a diagnostic procedure where images are taken from different angles (front, side, and angled) to assess the health of your spine. It helps identify issues like fractures, tumors, or degenerative conditions.

13 services13 patients

Nuclear medicine study of stomach to assess emptying 78264

A nuclear medicine study of the stomach assesses how quickly food leaves the stomach. A safe, radioactive substance is added to a meal. The radiation emitted is tracked, creating images that show the food's progress through the stomach. It's non-invasive and painless.

13 services13 patients

X-ray of ribs on side of body, 2 views 71100

This procedure involves taking two separate X-ray images of your ribs from different angles. It's a non-invasive test that helps visualize the bones and surrounding areas to detect any abnormalities or injuries. You'll be positioned carefully to capture the best images.

12 services12 patients

X-ray of ankle, 2 views 73600

An X-ray of the ankle, 2 views, is a quick, painless test that produces images of the bones and joints in your ankle. Two different angles are used to provide a more complete picture. It helps detect fractures, sprains, arthritis, or other abnormalities. It's safe and typically takes only a few minutes.

12 services11 patients

Limited ultrasound scan of 1 breast 76642

12 services12 patients

Diagnostic mammography of both breasts 77066

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230038

Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County

Emergency services Birthing friendly

Mercy Health Saint Mary's

Acute Care Hospitals · Grand Rapids, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230059

Location200 Jefferson Avenue SEGrand Rapids, MI 49503 · Kent County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.05/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

97.26

Improvement Activities

Cost

51.86

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIMOTHY RAY CROSSETT MD

Radiology (Diagnostic Radiology)

620 SKYLINE DRIVE
JACKSON, TN 38301

Madison County (731) 541-6174

SELECT SPECIALTY HOSPITAL - WEST TENNESSEE, LLC

Long Term Care Hospital

620 SKYLINE DRIVE, 5TH AND 6TH FLOORS
JACKSON, TN 38301

Madison County (717) 972-1100

MRS. TWONIA MICHELLE GOYER FNP

Nurse Practitioner

620 SKYLINE DRIVE
JACKSON, TN 38301

Madison County (731) 541-6174

JACKSON MADISON COUNTY GENERAL HOSPITAL

Rehabilitation Unit

620 SKYLINE DRIVE
JACKSON, TN 38301

Madison County (731) 541-6930

DR. ALLEN L SCHLAMP M.D.

Radiology (Diagnostic Radiology)

620 SKYLINE DRIVE
JACKSON, TN 38301

Madison County (731) 660-8759

DR. JAMES LEE ELLIS JR. M.D.

Radiology (Diagnostic Radiology)

620 SKYLINE DRIVE
JACKSON, TN 38301

Madison County (731) 541-6174

JASON CLARK

Nurse Anesthetist, Certified Registered

620 SKYLINE DRIVE
JACKSON, TN 38301

Madison County (731) 541-7070

ANITA L WYNN C.R.N.A.

Nurse Anesthetist, Certified Registered

620 SKYLINE DRIVE
JACKSON, TN 38301

Madison County (731) 541-7070

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 Laura Ross's NPI number?

The NPI number for Laura Ross is 1710133376. It was assigned to this individual provider in the NPPES registry on August 14, 2008.

Where is Laura Ross located?

Laura Ross practices at 620 Skyline Drive, Jackson, TN 38301. The listed phone number is (731) 541-6174.

What is Laura Ross's specialty?

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

Is Laura Ross enrolled in Medicare?

Yes. Laura Ross is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Laura Ross's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Laura Ross reassigns Medicare benefits to 3 organizations: Jackson Madison County General Hospital (Jackson, TN), Jackson Radiology Associates PA (Jackson, TN) and Kent Radiology PC (Grand Rapids, MI). Each 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 Laura Ross's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Laura Ross accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Laura Ross 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.

Is Laura Ross affiliated with any hospitals?

According to CMS data, Laura Ross is affiliated with Spectrum Health and Mercy Health Saint Mary's.

When was this NPI record last updated?

The NPPES record for Laura Ross was last updated on August 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.