1801867890 NPI number — OPEN MRI ON 280, LLC

Table of content: DIANE SCHOLZ REGONINI SLP (NPI 1639430143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801867890 NPI number — OPEN MRI ON 280, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPEN MRI ON 280, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801867890
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/28/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 932602
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31193-2602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-870-1979
Provider Business Mailing Address Fax Number:
205-870-1929

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 INDEPENDENCE PLZ STE 140
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMEWOOD
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35209-2629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-870-1979
Provider Business Practice Location Address Fax Number:
205-870-1929
Provider Enumeration Date:
01/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
TRACI
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF BILLING
Authorized Official Telephone Number:
706-256-3450

Provider Taxonomy Codes

  • Taxonomy code: 261QM1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1600679 . This is a "UHC - PROVIDER NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1124000344 . This is a "RUTH SNOW, MD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1235111451 . This is a "DR. CECIL ELAND - NPI NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 529913290 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1427030642 . This is a "ROBERT EICHELBERGER, MD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 470001761 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1023040409 . This is a "N. MELINDA BERGQUIST, MD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1306051164 . This is a "JAMES SPANN, M.D, NPI #" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51511247 . This is a "BCBS - FACILITY ID #" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51116995 . This is a "JAMES SPANN, M.D. - BCBS ID #" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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