SOUTHLAKE MRI & DIAGNOSTIC CENTER LLC (NPI# 1134178148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134178148 |
| Entity Type | Organization |
| Organization Name | SOUTHLAKE MRI & DIAGNOSTIC CENTER LLC |
| Practice Address |
108 E 90th Dr Merrillville IN 46410-7160 |
| Practice Telephone | 2197951801 |
| Practice Fax Number | 2197951802 |
| Mailing Telephone | 2197951801 |
| Mailing Fax Number | 2197951802 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2013-02-06 |
| Authorized Official Name | RAMAN CHOPRA (PRINCIPAL) |
| Authorized Official Telephone | 2197362700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| N | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
XM017160 | IN | Ambulatory Health Care Facilities |
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
XF200740 | IN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200500590 | 05 |
| Street Address |
108 E 90TH DR |
| City | MERRILLVILLE |
| State | IN |
| Zip Code | 46410-7160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023636867 | Lena Danielle Clouse | Pharmacist | Genoa Healthcare LLC, 8555 Taft Street, Merrillville, IN 46410 | 2020-07-08 |
| 1134752728 | All In One Therapy, LLC | Speech-Language Pathologist | 1800 W 84th Drive, Merrillville, IN 46410 | 2020-02-21 |
| 1134759335 | David John Kujawa | Social Worker | 8398 Mississippi St., Merrillville, IN 46410 | 2020-01-16 |
| 1619513603 | Activate Healthcare - Plumbers Local 210 Clinic | Clinic/Center | 2905 E 83rd Place, Merrillville, IN 46410 | 2019-11-25 |
| 1568946994 | Larry Smith | Case Manager/Care Coordinator | 233 E 83, Merrillville, IN 46410 | 2018-09-21 |
| 1114401536 | The Sheet People | Durable Medical Equipment & Medical Supplies | 8874 Louisiana Street, Merrillville, IN 46410 | 2018-09-21 |
| 1659858439 | Heather Grinder | Hearing Instrument Specialist | 9120 Connecticut Dr., Suite C, Merrillville, IN 46410 | 2018-07-24 |
| 1710463872 | Mitchell G Smith | Optometrist | 1601 E 81st Ave, Merrillville, IN 46410 | 2018-07-12 |
| 1336631753 | Nwi Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 1454 E. 86th Place, Merrillville, IN 46410 | 2018-06-01 |
| 1659860427 | Wendell B Fleming | Counselor | 230 West 175th Place, Apartment I, Merrillville, IN 46410 | 2018-05-07 |
| Find all providers in zip 46410 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750471470 | Indiana Regional P E T and Imaging Center, LLC | Clinic/Center | 7891 Broadway Ste A, Merrillville, IN 46410-5556 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286973 | Reid Physician Associates Inc | Clinic/Center | 1154 S State Road 1 Ste 2, Cambridge City, IN 47327-9513 | 2020-08-19 |
| 1710476668 | Reid Physician Associates, Inc. | Clinic/Center | 1350 Chester Blvd Ste E, Richmond, IN 47374-1959 | 2018-05-07 |
| 1548787203 | Deaconess Hospital, Inc. | Clinic/Center | 4949 Healthy Way Ste B, Evansville, IN 47715-1180 | 2017-08-24 |
| 1013452283 | George B. Pratt, Md | Clinic/Center | 9015 Crystal Lake Dr, Indianapolis, IN 46240-6414 | 2016-12-27 |
| 1134564016 | Chn Jmh Ventures LLC | Clinic/Center | 3000 S State Road 135 Ste 120, Greenwood, IN 46143-9829 | 2013-05-06 |
| 1578871257 | Smartview Imaging, LLC | Clinic/Center | 7818 E 96th St, Fishers, IN 46037-9629 | 2010-09-16 |
| 1255529335 | Greater Lafayette Health Services | Clinic/Center | 3482 Mcclure Ave, West Lafayette, IN 47906 | 2007-10-15 |
| 1205919982 | Northwestern Medical Imaging LLC | Clinic/Center | 1946 45th Ave, Munster, IN 46321-3917 | 2006-10-24 |
| 1720178726 | Indiana Mri of Evansville, LLC | Clinic/Center | 729 John St, Evansville, IN 47713-2754 | 2006-10-13 |
| 1790875706 | Indiana Mri, LLC | Clinic/Center | 3802 Industrial Blvd, Suite 4, Bloomington, IN 47403-5141 | 2006-10-13 |
| Find all providers with the same taxonomy | ||||
| City | MERRILLVILLE |
| Zip Code | 46410 |
Please comment or provide details below to improve the information on SOUTHLAKE MRI & DIAGNOSTIC CENTER 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.