DIAGNOSTIC RADIOLOGY OF LONDON PSC (NPI# 1255430054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255430054 |
| Entity Type | Organization |
| Organization Name | DIAGNOSTIC RADIOLOGY OF LONDON PSC |
| Other Organization Name | ADVANCED IMAGING AND OPEN MRI |
| Practice Address |
75 Walmart Plaza Dr Unit 4 Monticello KY 42633-7907 |
| Practice Telephone | 6063400009 |
| Practice Fax Number | 6063400113 |
| Mailing Telephone | 6063400009 |
| Mailing Fax Number | 6063400113 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2013-08-02 |
| Authorized Official Name | MS. MARY JO SHRUM (FACILITY DIRECTOR) |
| Authorized Official Telephone | 6063400009 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
33556 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | RAILROAD MEDICARE | DQ4251 | 01 |
| KY | 64353568 | 05 |
| Other Name | Type Code |
|---|---|
| Advanced Imaging and Open MRI | Doing Business As Name - Organization |
| Street Address |
75 WALMART PLAZA DR UNIT 4 |
| City | MONTICELLO |
| State | KY |
| Zip Code | 42633-7907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457963431 | Morgan Dishman | Pharmacist | 126 Franklin Dr, Monticello, KY 42633 | 2020-08-20 |
| 1942847686 | Burgess Drug Store Inc. | Pharmacy | 1 S. Creek Dr., Ste. #122, Monticello, KY 42633 | 2019-12-02 |
| 1639729460 | Lake Cumberland Therapy Center, Inc. | Developmental Therapist | 153 High Street, Monticello, KY 42633 | 2019-09-13 |
| 1053964965 | Faith Healthcare Inc | Nurse Practitioner | 126 Franklin Drive, Monticello, KY 42633 | 2019-07-19 |
| 1669936621 | Alisa D Wallace | Case Manager/Care Coordinator | 803 Columbia Ave, Monticello, KY 42633 | 2019-01-24 |
| 1194232207 | Jacob Dudley Coffey | Nurse Practitioner | 1 S Creek Dr Ste 102606, Monticello, KY 42633 | 2018-01-10 |
| 1245581578 | Joleen Nyesa Levering | Pharmacist | 1078 North Main Streeet, Monticello, KY 42633 | 2012-09-26 |
| 1194085977 | Steven M Tallent II | Dentist | 1225 N. Main St., Brummett Cosmetic and Family Dentistry, Monticello, KY 42633 | 2012-05-25 |
| 1245376243 | Diagnostic Radiology of London | Specialist | 1455 E Hwy 90 By-pass Unit #4, Monticello, KY 42633 | 2007-01-29 |
| 1639241433 | Hicks Enterprises of Monticello, LLC | Nursing Facility/Intermediate Care Facility | 1801 W. Hwy. 90 By-pass, Monticello, KY 42633 | 2006-11-15 |
| Find all providers in zip 42633 | ||||
| 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 |
|---|---|---|---|---|
| 1972785715 | Eric D Johnson | Radiology | 75 Wal-mart Plaza Rd Unit #4, Monticello, KY 42633-2314 | 2007-12-04 |
| 1447295944 | Raymond L Kercher | Radiology | 555 N Jefferson St, Monticello, FL 32344-2060 | 2006-06-18 |
| 1295034908 | Utah Valley Radiology Assoc | Radiology | 380 W. 100 N., Monticello, UT 84535 | 2011-03-21 |
| 1114966843 | William Mitchell Hall | Radiology | 166 Hospital St, Monticello, KY 42633-2416 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891300208 | Tammy Jo Wooding | Radiology | 2175 Rolling Hills Dr, Covington, KY 41017-5155 | 2020-09-11 |
| 1225535966 | Proscan Radiology Northern Kentucky, LLC | Radiology | 350 Thomas More Pkwy Ste 170, Crestview Hills, KY 41017 | 2018-04-10 |
| 1174037949 | Justin Byron Hall | Radiology | 3452 Milam Ln, Lexington, KY 40502-3652 | 2017-11-30 |
| 1073046611 | Radiology Physician Solutions of Florida, LLC | Radiology | 106 Argyll Cir, Hazard, KY 41701-8932 | 2017-04-11 |
| 1750731048 | Brent A Pressman | Radiology | 800 Rose St Rm Hx-315, Lexington, KY 40536-1227 | 2016-06-16 |
| 1730541046 | Michael Daniel Dahle | Radiology | 530 S Jackson St # St-c07, Louisville, KY 40202-1675 | 2016-03-25 |
| 1245600949 | Advanced Ultrasound and Imaging LLC | Radiology | 7806 Turtle Run Ct, Prospect, KY 40059-8334 | 2015-10-07 |
| 1952783672 | Harit Kapoor | Radiology | 800 Rose St Rm No, Lexington, KY 40536-4818 | 2015-06-19 |
| 1093122046 | Kbc Somerset Imaging Pllc | Radiology | 40 Turpen Ct, Somerset, KY 42503-3464 | 2014-07-22 |
| 1952722142 | Telerad of Kentucky Account Management LLC | Radiology | 1701 West Ln, Nicholasville, KY 40356-9614 | 2013-12-15 |
| Find all providers with the same taxonomy | ||||
| City | MONTICELLO |
| Zip Code | 42633 |
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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.