MEDICARE: OUTPATIENT IMAGING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1528901295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUTPATIENT IMAGING LLC

Provider Business Mailing Address
First Line	:	800 CRESCENT CENTRE DR STE 400
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-7270
Country	:	US
Telephone Number	:	615-261-2306
Fax Number	:	855-588-3545

Provider Business Practice Location Address
First Line	:	1331 LADY ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3319
Country	:	US
Telephone Number	:	615-261-2306
Fax Number	:	855-588-3545

Authorized Official
Title or Position	:	CEO
Name	:	AMY STOUT
Credential	:
Telephone Number	:	615-261-2306

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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