MOBILE DIAGNOSTIC SERVICES, INC. (NPI# 1073654141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073654141 |
| Entity Type | Organization |
| Organization Name | MOBILE DIAGNOSTIC SERVICES, INC. |
| Practice Address |
25 S Old Baltimore Pike Ste 104 Newark DE 19702-1540 |
| Practice Telephone | 3022922700 |
| Practice Fax Number | 3022922702 |
| Mailing Telephone | 3022922700 |
| Mailing Fax Number | 3022922702 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2013-09-02 |
| Authorized Official Name | MR. JOHN J GRAY III (CEO/PRESIDENT) |
| Authorized Official Telephone | 3022397700 |
| Authorized Official Credential | RDMS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
1990032819 | DE | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | X000596201 | 05 | |
| TX | AETNA | 0005018072 | 01 |
| PA | HIGHMARK INC | 000330426 | 01 |
| PA | HIGHMARK MEDICARE | 021642 | 01 |
| TX | UNITED AMERICAN INSURANCE | 574438109 | 01 |
| MD | 405833000 | 05 |
| Street Address |
25 S OLD BALTIMORE PIKE STE 104 |
| City | NEWARK |
| State | DE |
| Zip Code | 19702-1540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689618951 | Diagnostic Medical Services Inc. | Radiologic Technologist | 25 S Old Baltimore Pike, Suite 104, Newark, DE 19702-1540 | 2006-06-16 |
| 1568932721 | A Center for Mental Wellness, Inc. | Psychologist | 25 S Old Baltimore Pike, Lafayette Building 1, Suite 201, Newark, DE 19702 | 2018-11-30 |
| 1588131841 | Vanessa Foulk | Counselor | 25 S Old Baltimore Pike, Newark, DE 19702-1540 | 2018-10-25 |
| 1316461072 | Rene Gregston Brathwaite | Counselor | 25 S Old Baltimore Pike, Newark, DE 19702-1540 | 2017-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407467814 | Leilanie Redondiez | Physical Therapist | 110 Blue Ridge Circle, Newark, DE 19702 | 2020-08-11 |
| 1285118679 | A Center for Mental Wellness Community Support Programs, LLC | Substance Abuse Rehabilitation Facility | 25 S. Old Baltimore Pike, Lafayette Building 1, Suite 201, Newark, DE 19702 | 2018-09-20 |
| 1124510854 | Shena Williams | Counselor | 1423 Capital Trail Rd, Newark, DE 19702 | 2018-05-30 |
| 1437664737 | Excellence Home Care LLC | Home Health | 122 Delaware Street, New Castle, DE 19702 | 2017-12-08 |
| 1710496773 | Kirt Leigh Randolph | Physical Therapy Assistant | 229 Barrett Run Place, Newark, DE 19702 | 2017-09-21 |
| 1871014399 | Edeline Elicin | Marriage & Family Therapist | 260 Chapman Road, Suite 100-b, Newark, DE 19702 | 2017-07-06 |
| 1831646454 | Rickia Izetta Spivey-kennedy | Counselor | 36 Avignon Drive, Newark, DE 19702 | 2016-09-01 |
| 1134585748 | Thomas Wolters | Pharmacist | 248 Chaoman Road, Newark, DE 19702 | 2016-01-12 |
| 1851700686 | Candice Roberts | Nurse Practitioner | 100 Biddle Ave Ste 101, Newark, DE 19702 | 2014-08-06 |
| 1316367428 | Evyline Chioma | Occupational Therapist | 25 Buttonwood Ct., Newark, DELAWARE 19702 | 2014-04-16 |
| Find all providers in zip 19702 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740706175 | Delaware Radiology Associates Pa | Radiology | 6 Omega Dr Bldg L, Newark, DE 19713-2056 | 2017-08-17 |
| 1912133109 | Oluwole Ayodeji Tairu | Radiology | 150 Bergen St Level C, Newark, NJ 07103-2496 | 2009-06-02 |
| 1548435290 | Denis Primakov | Radiology | 4755 Ogletown Stanton Rd Ste 1752, Newark, DE 19718-2200 | 2008-04-24 |
| 1518163773 | Samson Wong | Radiology | 4755 Ogletown Stanton Rd Rm 1752, Newark, DE 19718-6402 | 2007-06-25 |
| 1386864635 | Open Mri & Imaging of Newark | Radiology | 243 Chestnut Street, Newark, NJ 07105-6501 | 2007-04-27 |
| 1194853952 | Anton Grant Delport | Radiology | 4755 Ogletown-stanton, Roadroom 2a00-christiana Hospital, Newark, DE 19718-0001 | 2007-03-01 |
| 1316028665 | Edward A Del Grosso | Radiology | 1320 W. Main Street, Newark, OH 43055-1822 | 2006-10-17 |
| 1720172885 | Delaware Womens Imaging LLC | Radiology | J-24 Omega Drive, Newark, DE 19713 | 2006-10-03 |
| 1659484467 | An Open Mri Imaging of Newark, LLC | Radiology | 243 Chestnut St., Newark, NJ 07105-6501 | 2006-08-16 |
| 1083645394 | Helen Sax | Radiology | J24 Omega Drive, Newark, DE 19713-2060 | 2006-07-05 |
| Find all providers in NEWARK | ||||
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| 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.