LEBANON PET SCAN CENTER, LLC (NPI# 1114551132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114551132 |
| Entity Type | Organization |
| Organization Name | LEBANON PET SCAN CENTER, LLC |
| Practice Address |
103 Physicians Way Ste 100 Lebanon TN 37090-4129 |
| Mailing Address |
P.o. Box 440149 Nashville TN 37244 |
| Practice Telephone | 6153290570 |
| Mailing Telephone | 6153290570 |
| Mailing Fax Number | 6153290579 |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2020-02-28 |
| Authorized Official Name | PATTIE DOUGLAS (PAYER RELATIONS MANAGER) |
| Authorized Official Telephone | 6155146876 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
103 PHYSICIANS WAY STE 100 |
| City | LEBANON |
| State | TN |
| Zip Code | 37090-4129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376926840 | Kathryn Mccloud | Physical Therapist | 163 Business Park Drive, Lebanon, TN 37090 | 2015-07-02 |
| 1811380926 | Samantha Smith | Nurse Practitioner | 101 Physicians Way Ste 111, Lebanon, TN 37090 | 2015-03-13 |
| 1760575831 | Ronald Scott Forczek | Respiratory Therapist, Certified | 8265 Trousdale Ferry Pike, Lebanon, TN 37090 | 2006-10-02 |
| 1649271206 | Roy C. Terry | Orthopaedic Surgery | 101 Physicians Way, Ste. 111, Lebanon, TN 37090 | 2005-08-04 |
| 1679570345 | Rhoda S Powers | Nurse Practitioner | 100 Physicians Way, Lebanon, TN 37090 | 2005-07-07 |
| 1285103689 | Jessica A Barron | Dermatology | 107 Glidepath Way, Lebanon, TN 37090 | 2018-11-15 |
| 1811109614 | Susan Anissa Hatcher | Occupational Therapy Assistant | 2215 Callis Rd, Lebanon, TN 37090 | 2007-05-04 |
| 1558386771 | Andre C Olivier | Internal Medicine | 100 Physicians Way, Suite 300, Lebanon, TN 37090 | 2006-07-12 |
| 1326030156 | Tennessee Orthopedics, P.C. | Orthopaedic Surgery | 101 Physicians Way, Ste. 111, Lebanon, TN 37090 | 2005-08-18 |
| 1154686673 | Stephanie Ruckman | Nurse Practitioner | 115 Moriah Dr, Lebanon, TN 37090-0731 | 2012-07-10 |
| Find all providers in zip 37090 | ||||
| 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 |
|---|---|---|---|---|
| 1417319161 | Joseph Martin Clark | Radiology | 16 E High St, Lebanon, PA 17042-5454 | 2016-03-22 |
| 1902900061 | Susan B Humphreys Md PC | Radiology | Carroll & Tate Streets, Lebanon, VA 24266 | 2006-09-11 |
| 1467499079 | Philip Dennison Stieg | Radiology | Fourth & Walnut Streets, Radiology Department, Lebanon, PA 17042-1281 | 2006-06-01 |
| 1285689513 | Vision Imaging of Lebanon LLC | Radiology | 805 Helen Dr, Lebanon, PA 17042-7493 | 2006-05-24 |
| 1902876352 | Radiology & Nuclear Medicine Associates | Radiology | 1411 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2006-01-26 |
| 1669469532 | Daniel William Hottenstein | Radiology | 231 Valley Rd, Lebanon, PA 17042-8930 | 2005-10-05 |
| 1811998073 | Susan Barrow Humphreys | Radiology | Carroll & Tate Sts, Box 3600, Lebanon, VA 24266 | 2005-08-09 |
| 1346246436 | Lebanon Diagnostic Imaging, LLC | Radiology | 960 Isabel Dr, Lebanon, PA 17042-7482 | 2005-06-23 |
| 1386175859 | Joshua Harris Litchman | Radiology | 1 Medical Dr, Lebanon, NH 03756 | 2017-03-25 |
| 1821477175 | David S Sargent | Radiology | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2015-05-20 |
| Find all providers in LEBANON | ||||
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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.