NATIONAL PET CENTERS LLC (NPI# 1235169301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235169301 |
| Entity Type | Organization |
| Organization Name | NATIONAL PET CENTERS LLC |
| Other Organization Name | GREAT LAKES MEDICAL IMAGING |
| Practice Address |
19250 Bagley Road, Suite 203 National Pet Centers LLC Dba Great Lakes Medical Imagin Middleburg Heights OH 44130 |
| Mailing Address |
5313 Dona Road Julian NC 27283 |
| Practice Telephone | 4402343321 |
| Practice Fax Number | 4402343323 |
| Mailing Telephone | 3362742844 |
| Mailing Fax Number | 3362742817 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2011-01-13 |
| Authorized Official Name | MR. DAVID L GILLILAND (OWNER) |
| Authorized Official Telephone | 3362742844 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471N0900X |
Radiologic Technologist Specialization: Nuclear Medicine Technology |
Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RENDERING PROVIDER NUMBER | 1275583791 | 01 | |
| ANTHEM BLUE SHIELD | 192232 | 01 | |
| OH | 2326478 | 05 | |
| ANTHEM BC/BS | 192322 | 01 | |
| RENDERING PROVIDER NUMBERS | 1093798720 | 01 |
| Other Name | Type Code |
|---|---|
| Great Lakes Medical Imaging | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447577440 | National Pet Centers LLC | Clinic/Center | 4349 S Treadaway Blvd, Ste B, Abilene, TX 79602-7803 | 2010-04-29 |
| Street Address |
19250 BAGLEY ROAD, SUITE 203 NATIONAL PET CENTERS LLC DBA GREAT LAKES MEDICAL IMAGIN |
| City | MIDDLEBURG HEIGHTS |
| State | OH |
| Zip Code | 44130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545427 | Northeast Care Center, Inc. | Intermediate Care Facility, Mentally Retarded | 19080 Bagley Road, Middleburg Hts., OH 44130 | 2019-12-16 |
| 1982189148 | Carl Steinhoff | Registered Nurse | 13766 Cherokee Trail, Middleburg Heights, OH 44130 | 2018-10-03 |
| 1649756321 | Beatrice Shepherd | Counselor | 5253 Hauserman Rd Apt 212, Parma, OH 44130 | 2018-07-16 |
| 1841705068 | New Heights Aba, LLC | Behavioral Analyst | 6908 Engle Rd Ste D, Middleburg Heights, OH 44130 | 2017-12-11 |
| 1275059842 | Tynisha Nicole Nation | Registered Nurse | 6431 Olde York, Parma Hts, OH 44130 | 2017-08-16 |
| 1609328558 | Lisa Wolanin | Physical Therapist | 186970bagley Road, Middleburg Hts, OH 44130 | 2016-10-26 |
| 1184074205 | Tanya Makowski | Nurse Practitioner | 7215 Old Oak Blvd Ste A420, Cleveland, OH 44130 | 2016-06-20 |
| 1093165706 | Dana Hyde | Dentist | 7528 Pearl Rd, Middleburg Heights, OH 44130 | 2016-06-14 |
| 1689046625 | Kimberly Ann Piro | Nurse Practitioner | 12240 Zona Ln, Parma, OH 44130 | 2015-10-29 |
| 1225400088 | Larrise Williford | Registered Nurse | 11491 Sharon Dr Apt C705, Parma, OH 44130 | 2015-10-20 |
| Find all providers in zip 44130 | ||||
| Taxonomy Code | 2471N0900X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Nuclear Medicine Technology |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376703124 | Tatiana Victorovna Fryer | Radiologic Technologist | 10607 Cinderella Dr, Cincinnati, OH 45242 | 2008-06-16 |
| 1104014299 | David Charles Kelly Jr. | Radiologic Technologist | 8915 Cherry St, Blue Ash, OH 45242-7846 | 2007-10-15 |
| 1578599882 | Diagnostics Imaging, LLC | Radiologic Technologist | 319 Marion Pike, Coal Grove, OH 45638-2958 | 2006-06-26 |
| 1235354929 | Stephanie N Lee | Radiologic Technologist | 4100 W Third St, Dayton, OH 45429 | 2007-04-16 |
| 1437374808 | Jeffrey Timothy Willsey | Radiologic Technologist | 4100 W 3rd St, Dayton, OH 45428-9000 | 2007-04-13 |
| 1003031410 | Amy Joann Mcmullen | Radiologic Technologist | 4100 W 3rd St, Dayton, OH 45428-9000 | 2007-04-13 |
| 1770513830 | Dedicated Pet Imaging, LLC | Radiologic Technologist | 2315 Sunset Blvd, Steubenville, OH 43952-2496 | 2006-07-04 |
| City | MIDDLEBURG HEIGHTS |
| Zip Code | 44130 |
Please comment or provide details below to improve the information on NATIONAL PET CENTERS 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.