Healthcare Provider Details
I. General information
NPI: 1619386869
Provider Name (Legal Business Name): ADVANCED DIAGNOSTIC IMAGING, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2014
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2025 N MOUNT JULIET RD STE 130
MT JULIET TN
37122-3994
US
IV. Provider business mailing address
3024 BUSINESS PARK CIR
GOODLETTSVILLE TN
37072-3132
US
V. Phone/Fax
- Phone: 615-885-0200
- Fax:
- Phone: 615-851-6033
- Fax: 615-851-2018
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHAD
C
CALENDINE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 615-851-6033