MEDICAL IMAGING OF FREDERICKSBURG, LLC (NPI# 1013950112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013950112 |
| Entity Type | Organization |
| Organization Name | MEDICAL IMAGING OF FREDERICKSBURG, LLC |
| Practice Address |
1201 Sam Perry Blvd Suite 102 Fredericksburg VA 22401-4490 |
| Practice Telephone | 5407417025 |
| Practice Fax Number | 5407417048 |
| Mailing Telephone | 5407417025 |
| Mailing Fax Number | 5407417048 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | MR. FRED M. RANKIN III (PRESIDENT & CEO) |
| Authorized Official Telephone | 5407411414 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM | 292008 | 01 |
| VA | MAMSI | 317546 | 01 |
| VA | CAREFIRST | 3165 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811193899 | Medical Imaging of Fredericksburg, LLC | Clinic/Center | 125 Woodstream Boulevard, Suite 109, Stafford, VA 22556 | 2007-06-26 |
| 1841239886 | Medical Imaging of Fredericksburg, LLC | Clinic/Center | 10401 Spotsylvania Ave, Suite #100-1, Fredericksburg, VA 22408-2691 | 2006-06-05 |
| 1306884739 | Medical Imaging of Fredericksburg, LLC | Clinic/Center | 1300 Hospital Dr, Fredericksburg, VA 22401-8451 | 2006-06-04 |
| Street Address |
1201 SAM PERRY BLVD SUITE 102 |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-4490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215471941 | Brittany Jillian Cary | Nurse Practitioner | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2016-12-14 |
| 1811325764 | Mishell Ellis | Nurse Practitioner | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2013-10-30 |
| 1821259557 | Melissa Ann Chambers | Clinic/Center | 1201 Sam Perry Blvd, Suite 101, Fredericksburg, VA 22401-4490 | 2008-06-25 |
| 1457552143 | Lynn Anne Delash | Occupational Therapist | 1201 Sam Perry Blvd, Suite 240, Fredericksburg, VA 22401-4490 | 2007-05-30 |
| 1992906010 | Karen Anne Franklin | Physical Therapist | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2007-05-29 |
| 1801097738 | Susan Patricia Rohde | Speech-Language Pathologist | 1201 Sam Perry Blvd, Ste 240, Fredericksburg, VA 22401-4490 | 2007-05-29 |
| 1013128461 | Susan Reiko Hoshi | Physical Therapist | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2007-05-25 |
| 1285845198 | Stephanie Noelle Campbell | Speech-Language Pathologist | 1201 Sam Perry Blvd, Suite 240, Fredericksburg, VA 22401-4490 | 2007-05-24 |
| 1932319712 | Shauna Renee Dickinson | Speech-Language Pathologist | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2007-05-23 |
| 1003026444 | Carol Gaudio | Occupational Therapy Assistant | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2007-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1265074231 | Anna Kelleher | Behavior Technician | 1411 Princess Anna St, Frericksburg, VA 22401 | 2019-10-11 |
| 1649824152 | Zaan Z Ali | Audiologist | 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 | 2019-08-01 |
| 1790342426 | Michael Williams Jr. | Physician Assistant | 411 B Park Hill Dr, Frederickburg, VA 22401 | 2019-05-29 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1922579630 | Primary and Urgent Care LLC | Family Medicine | Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 | 2018-12-07 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841239886 | Medical Imaging of Fredericksburg, LLC | Clinic/Center | 10401 Spotsylvania Ave, Suite #100-1, Fredericksburg, VA 22408-2691 | 2006-06-05 |
| 1780792978 | Radiologic Associates of Fredericksburg Ltd | Clinic/Center | 1201 Sam Perry Blvd, Suite 265, Fredericksburg, VA 22401-4490 | 2006-08-28 |
| 1699711093 | Radiologic Associates of Fredericksburg Ltd | Clinic/Center | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2006-06-22 |
| 1306884739 | Medical Imaging of Fredericksburg, LLC | Clinic/Center | 1300 Hospital Dr, Fredericksburg, VA 22401-8451 | 2006-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346898897 | Viva Richmond LLC | Clinic/Center | 6600 W Broad St Ste 200b, Richmond, VA 23230-1709 | 2019-08-28 |
| 1699328500 | Fairfax Radiological Consultants PC | Clinic/Center | 8260 Willow Oaks Corporate Dr Ste 200, Fairfax, VA 22031-4515 | 2019-07-19 |
| 1215438544 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Clinic/Center | 12320 W Broad St Ste 100a, Richmond, VA 23233 | 2018-02-22 |
| 1447538558 | Medarva Imaging | Clinic/Center | 1630 Wilkes Ridge Pkwy Ste 100, Richmond, VA 23233-7460 | 2011-07-25 |
| 1982995296 | Grafton Ct Imaging LLC | Clinic/Center | 4030 George Washington Mem Hwy Ste A, Grafton, VA 23692-2619 | 2011-04-21 |
| 1447555115 | Bon Secours-virginia Healthsource, Inc. | Clinic/Center | 7110 Forest Ave Ste 100, Richmond, VA 23226-3762 | 2011-01-11 |
| 1356646004 | Bon Secours-virginia Healthsource, Inc. | Clinic/Center | 11525 Midlothian Tpke Ste 103, Richmond, VA 23235-4763 | 2011-01-11 |
| 1255586277 | Bon Secours - Richmond Community Hospital, Incorporated | Clinic/Center | 4630 S. Laburnum Ave., Suite C, Richmond, VA 23231 | 2008-11-18 |
| 1811193899 | Medical Imaging of Fredericksburg, LLC | Clinic/Center | 125 Woodstream Boulevard, Suite 109, Stafford, VA 22556 | 2007-06-26 |
| 1801946090 | Patient First Ct, LLC | Clinic/Center | 8247 Meadowbridge Rd, Mechanicsville, VA 23116-2329 | 2007-01-11 |
| Find all providers with the same taxonomy | ||||
| City | FREDERICKSBURG |
| Zip Code | 22401 |
Please comment or provide details below to improve the information on MEDICAL IMAGING OF FREDERICKSBURG, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.