MEDICARE: PHYSICIAN IMAGING OF WASHINGTON HOSPITAL CENTER, 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
2	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1902632078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN IMAGING OF WASHINGTON HOSPITAL CENTER, 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	:

Provider Business Practice Location Address
First Line	:	5454 WISCONSIN AVE STE 1700
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20815-6951
Country	:	US
Telephone Number	:	615-261-2306
Fax Number	:

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

Provider Enumeration Date	:	09/13/2024
Last Update Date	:	12/16/2025

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