EXECUTIVE IMAGING, LLC (NPI# 1073121521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073121521 |
| Entity Type | Organization |
| Organization Name | EXECUTIVE IMAGING, LLC |
| Practice Address |
1069 Delaware Ave Ste 104 Marion OH 43302-6459 |
| Practice Telephone | 7407516828 |
| Practice Fax Number | 7407516829 |
| Mailing Telephone | 7407516828 |
| Mailing Fax Number | 7407516829 |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2020-07-21 |
| Authorized Official Name | BRIAN D HEMPSTEAD (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7403877200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| Street Address |
1069 DELAWARE AVE STE 104 |
| City | MARION |
| State | OH |
| Zip Code | 43302-6459 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467094284 | Nichole Mattix | Case Management | 1199 Delaware Avenue, Marion, OH 43302 | 2019-10-14 |
| 1770138208 | Peyton Feeney | Nurse Practitioner | 1065 Delaware Ave. Ste. A, Marion, OH 43302 | 2019-08-01 |
| 1609350891 | Progressive Living, Inc | Home Health | 3523 Pleasant Hill R.d., Marion, OH 43302 | 2018-09-24 |
| 1962989400 | Adena Pennington | Community Health Worker | 320 Executive Drive, Marion, OH 43302 | 2018-07-27 |
| 1407372030 | Kelli Ann Love | Licensed Practical Nurse | 559 Uncapher Ave, Marion, OH 43302 | 2017-08-15 |
| 1063947513 | Netcare Usa LLC | In Home Supportive Care | 1275 Lake Blvd, 6, Marion, OH 43302 | 2017-04-21 |
| 1003350448 | Ethan Thomas Craig | Social Worker | 1199 Delaware Ave Ste 107, 195 N Grant Ave, Columbus, Oh 43215, Marion, OH 43302 | 2016-12-04 |
| 1326590043 | Occupational Health Centers of Ohio, Pa, Co | Clinic/Center | 1300 Marion Agosta Road, Marion, OH 43302 | 2016-10-28 |
| 1295115459 | Bradley Neil Casto | Hearing Instrument Specialist | 864 East Center St, Marion, OH 43302 | 2015-06-03 |
| 1881003630 | Billie Roach | Home Health Aide | 182 Barkswood Rd., Marion, OH 43302 | 2014-08-06 |
| Find all providers in zip 43302 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780927723 | Bmx Imaging Center, LLC | Clinic/Center | 1069 Delaware Ave, Suite 104b, Marion, OH 43302-1400 | 2013-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912532904 | Northern Ohio Medical Specialists, LLC | Clinic/Center | 26151 Euclid Ave Ste 130, Euclid, OH 44132-3300 | 2020-03-10 |
| 1326510868 | Genetesis, Inc. | Clinic/Center | 5412 Courseview Dr Ste 150, Mason, OH 45040-2483 | 2018-12-21 |
| 1225507551 | Imaging Support Services Inc | Clinic/Center | 4244 Aicholtz Road Suite D, Cincinnati, OH 45245 | 2018-11-15 |
| 1710417605 | B&d Radiology Partners Pllc | Clinic/Center | 452 Ashsteade Ln, Cincinnati, OH 45255-3710 | 2017-06-14 |
| 1235671710 | Citran Xray LLC | Clinic/Center | 7774 Dayton Springfield Road, Fairborn, OH 45324-1996 | 2016-11-15 |
| 1598163164 | Fostoria Hospital Association | Clinic/Center | 455 W 4th St Ste 30, Fostoria, OH 44830-1864 | 2014-12-15 |
| 1487991360 | Birchcrest Holdings, LLC | Clinic/Center | 19250 Bagley Rd Ste 202, Cleveland, OH 44130 | 2013-01-11 |
| 1487922548 | Northern Ohio Medical Specialists, LLC | Clinic/Center | 2800 Hayes Ave # Bdlgc130, Sandusky, OH 44870 | 2011-12-05 |
| 1164726360 | Birchcrest Holdings, LLC | Clinic/Center | 4760 Richmond Rd Ste 300, Cleveland, OH 44128 | 2011-01-03 |
| 1215170824 | Value Added Imaging Services, LLC | Clinic/Center | 5192 Chillicothe Rd Ste 102, Chagrin Falls, OH 44022-4196 | 2009-04-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EXECUTIVE IMAGING, 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.