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1699072611 NPI number — IMAGING ASSOCIATES OF INDIANA, PC

NPI Number: 1699072611
Health Care Provider/Practitioner: IMAGING ASSOCIATES OF INDIANA, PC

Information about “1699072611” NPI (IMAGING ASSOCIATES OF INDIANA, PC) exists in 1699072611 in HTML format HTML  |  1699072611 in plain Text format TXT  |  1699072611 in PDF (Portable Document Format) PDF  |  1699072611 in an XML format XML  formats.

NPI Number : 1699072611 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1699072611",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "IMAGING ASSOCIATES OF INDIANA, 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": "PO BOX 208807",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DALLAS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75320-8807",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "888-501-6087",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1201 S MAIN ST",
    "SecondLinePracticeLocationAddress": "ATTN: RADIOLOGY DEPARTMENT",
    "PracticeLocationAddressCityName": "CROWN POINT",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46307-8481",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "219-767-6320",
    "PracticeLocationAddressFaxNumber": "219-738-6714",
    "EnumerationDate": "02/28/2011",
    "LastUpdateDate": "09/30/2024",
    "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": "2085R0204X",
          "TaxonomyName": "Vascular & Interventional Radiology Physician",
          "LicenseNumber": "NONE",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2085R0202X",
          "TaxonomyName": "Diagnostic Radiology Physician",
          "LicenseNumber": "NONE",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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