PENRAD IMAGING LLC (NPI# 1275134611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275134611 |
| Entity Type | Organization |
| Organization Name | PENRAD IMAGING LLC |
| Practice Address |
1263 Lake Plaza Dr Ste 100 Colorado Springs CO 80906-3510 |
| Mailing Address |
Po Box 2989 Colorado Springs CO 80901-2989 |
| Practice Telephone | 7195931799 |
| Practice Fax Number | 7192653794 |
| Mailing Telephone | 7195931799 |
| Mailing Fax Number | 7192653794 |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-03 |
| Authorized Official Name | DEREK SCOTT BERGESON (RADIOLOGIST) |
| Authorized Official Telephone | 7195931799 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376038 | Penrad Imaging LLC | Clinic/Center | 2202 N Nevada Ave, Colorado Springs, CO 80907-6819 | 2020-11-03 |
| 1538760962 | Penrad Imaging LLC | Clinic/Center | 6011 E Woodmen Rd Ste 10, Colorado Springs, CO 80923-2603 | 2020-11-03 |
| 1851992291 | Penrad Imaging LLC | Clinic/Center | 4105 Briargate Pkwy Ste 115, Colorado Springs, CO 80920-3482 | 2020-11-03 |
| 1730780172 | Penrad Imaging LLC | Clinic/Center | 17230 Jackson Creek Pkwy Ste 100, Monument, CO 80132-7302 | 2020-11-03 |
| 1770105900 | Penrad Imaging LLC | Clinic/Center | 4925 N Nevada Ave, Colorado Springs, CO 80918-8600 | 2020-05-11 |
| 1003906868 | Penrad Imaging LLC | Clinic/Center | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 | 2006-10-13 |
| Street Address |
1263 LAKE PLAZA DR STE 100 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80906-3510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437797339 | Michael Crise | Behavior Technician | 1330 Qual Lake Loop Ste 120, Colorado Springs, CO 80906 | 2019-12-11 |
| 1730720541 | Amanda Salinas | Massage Therapist | 1235 Lake Plaza Drive Suite 230, Colorado Springs, CO 80906 | 2019-10-02 |
| 1225511488 | Sheila Meggison | Massage Therapist | 1235 Lake Plaza Drive, Suite 230, Colorado Springs, CA 80906 | 2018-09-12 |
| 1316429756 | Vivus Counseling Services LLC | Counselor | 108 East Cheyenne Rd Suite 201, Colorado Springs, CO 80906 | 2018-09-01 |
| 1043796949 | Erin Lee Recinos | Nurse Practitioner | 225 E Cheyenne Mountain Blvd Ste 220, Colorado Springs, CO 80906 | 2018-07-13 |
| 1982103875 | Savannah Adeline Rentrop | Behavior Technician | 2989 Broadmoor Valley Rd D, Colorado Springs, CO 80906 | 2018-02-06 |
| 1205335288 | Ross Knowlton | Behavior Technician | 1330 Quail Lake Loop Suite 200, Colorado Springs, CO 80906 | 2018-02-06 |
| 1942709845 | Adrienne Bohlen | Behavior Technician | 1330 Quail Lake Loop, Ste. 200, Colorado Springs, CO 80906 | 2018-02-06 |
| 1881110088 | Christine Gonzales | Nurse Practitioner | 2739 E Las Vegas St, Colorado Springs, CO 80906 | 2017-08-18 |
| 1225568470 | Larry Alwine | Counselor | 2860 South Circle Drive, Unit 250k, Colorado Springs, CO 80906 | 2017-06-19 |
| Find all providers in zip 80906 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376038 | Penrad Imaging LLC | Clinic/Center | 2202 N Nevada Ave, Colorado Springs, CO 80907-6819 | 2020-11-03 |
| 1538760962 | Penrad Imaging LLC | Clinic/Center | 6011 E Woodmen Rd Ste 10, Colorado Springs, CO 80923-2603 | 2020-11-03 |
| 1851992291 | Penrad Imaging LLC | Clinic/Center | 4105 Briargate Pkwy Ste 115, Colorado Springs, CO 80920-3482 | 2020-11-03 |
| 1376159681 | Uchealth Imaging Services LLC | Clinic/Center | 5818 N. Nevada, Suite 100, Colorado Springs, CO 80918 | 2020-09-22 |
| 1710546932 | Uch-mhs | Clinic/Center | 2685 Dublin Blvd., Colorado Springs, CO 80918-1358 | 2019-06-11 |
| 1922343243 | Citadel Terrace Imaging, LLC | Clinic/Center | 709 Citadel Dr E, Colorado Springs, CO 80909-5302 | 2012-11-28 |
| 1063011096 | Uchealth Imaging Services LLC | Clinic/Center | 5818 N. Nevada, Suite 110, Colorado Springs, CO 80918 | 2020-10-21 |
| 1770105900 | Penrad Imaging LLC | Clinic/Center | 4925 N Nevada Ave, Colorado Springs, CO 80918-8600 | 2020-05-11 |
| 1144880675 | Uch-mhs | Clinic/Center | 1 Olympic Plz, Colorado Springs, CO 80909-5780 | 2019-06-17 |
| 1518526441 | Uch-mhs | Clinic/Center | 4190 E Woodmen Rd, Ste 240, Colorado Springs, CO 80920-8075 | 2019-06-13 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80906 |
Please comment or provide details below to improve the information on PENRAD IMAGING 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.