NPI Code Detail JSON Logo

1396795951 NPI number — JEFFERSON RADIOLOGY, PC

NPI Number: 1396795951
Health Care Provider/Practitioner: JEFFERSON RADIOLOGY, PC

Information about “1396795951” NPI (JEFFERSON RADIOLOGY, PC) exists in 1396795951 in HTML format HTML  |  1396795951 in plain Text format TXT  |  1396795951 in PDF (Portable Document Format) PDF  |  1396795951 in an XML format XML  formats.

NPI Number : 1396795951 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396795951",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "JEFFERSON RADIOLOGY, PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "55 HARTLAND ST",
    "SecondLineMailingAddress": "SUITE 200",
    "MailingAddressCityName": "EAST HARTFORD",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06108-3244",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "860-528-2080",
    "MailingAddressFaxNumber": "860-291-6594",
    "FirstLinePracticeLocationAddress": "85 SEYMOUR ST STE 200",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HARTFORD",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06106-5509",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "860-289-3375",
    "PracticeLocationAddressFaxNumber": "860-783-5733",
    "EnumerationDate": "05/12/2006",
    "LastUpdateDate": "07/21/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LEBLEU",
    "AuthorizedOfficialFirstName": "SHARLEE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "VICE PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "480-321-7026",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207U00000X",
          "TaxonomyName": "Nuclear Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2085R0202X",
          "TaxonomyName": "Diagnostic Radiology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.