SOUTHWOOD PET SCAN, LLC (NPI# 1467491845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467491845 |
| Entity Type | Organization |
| Organization Name | SOUTHWOOD PET SCAN, LLC |
| Practice Address |
250 Debartolo Pl Building B Youngstown OH 44512-7004 |
| Practice Telephone | 3307290357 |
| Practice Fax Number | 3307290358 |
| Mailing Telephone | 3307290357 |
| Mailing Fax Number | 3307290358 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARY JO MORRIS (ENROLLMENT SPECIALIST) |
| Authorized Official Telephone | 4129375726 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
========= | PA | Allopathic & Osteopathic Physicians |
| Street Address |
250 DEBARTOLO PL BUILDING B |
| City | YOUNGSTOWN |
| State | OH |
| Zip Code | 44512-7004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891794129 | Asad Azarvan | Radiology | 250 Debartolo Pl, Youngstown, OH 44512-7004 | 2005-07-19 |
| 1578193967 | Alexandra Kristine Shivers | Nurse Practitioner | 250 Debartolo Pl, Youngstown, OH 44512-7004 | 2020-01-24 |
| 1841780467 | Maria Ann Hendrix | Nurse Practitioner | 250 Debartolo Pl, Youngstown, OH 44512-7004 | 2018-05-18 |
| 1477731073 | St Elizabeth Southwoods Imaging LLC | Clinic/Center | 250 Debartolo Pl, Bldg B, Youngstown, OH 44512-7004 | 2008-02-06 |
| 1144341462 | David J. Dunch, M. D., Inc. | Colon & Rectal Surgery | 250 Debartolo Pl, Suite 1640, Youngstown, OH 44512-7004 | 2007-04-03 |
| 1154357754 | The Heart Center of Northeastern Ohio Inc | Internal Medicine | 250 Debartolo Pl, Suite 2750, Youngstown, OH 44512-7004 | 2006-06-24 |
| 1457339376 | David J Dunch | Colon & Rectal Surgery | 250 Debartolo Pl, Suite 1640, Youngstown, OH 44512-7004 | 2006-01-03 |
| 1215919071 | Richard Thomas Esper | Internal Medicine | 250 Debartolo Pl, Suite 2750, Youngstown, OH 44512-7004 | 2005-11-17 |
| 1003807025 | Jeffrey C Halley | Internal Medicine | 250 Debartolo Pl, Suite 2750, Youngstown, OH 44512-7004 | 2005-10-31 |
| 1114917432 | Keith H Kuppler | Internal Medicine | 250 Debartolo Pl, Suite 2750, Youngstown, OH 44512-7004 | 2005-10-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248740 | Kimberly Vrabel | Counselor | 725 Boardman Canfield Road Road Unit 1 and Unit 2, Boardman, OH 44512 | 2020-09-02 |
| 1043830144 | Steffi Lorraine D'souza | Student in an Organized Health Care Education/Training Program | 8423 Market Street Suite 101 St. Elizabeth Boardman Hos, Boardman, OH 44512 | 2020-04-20 |
| 1427677830 | Shivani Sharma | Family Medicine | 8423 Market Street Suite 101, St Elizabeth Boardman Hospital, Boardman, OH 44512 | 2020-04-15 |
| 1417587825 | Ronny Zetts | Pharmacist | 308 Boardman-canfield Rd, Boardman, OH 44512 | 2020-01-24 |
| 1285105080 | Andrew Dawson | Nurse Practitioner | 883 Boardman Canfield Rd Ste 105, Youngstown, OH 44512 | 2018-12-06 |
| 1700374949 | Adam Leid | Student in an Organized Health Care Education/Training Program | St Elizabeth Boardman Hospital - Medical Education Dept, 8401 Market Street, Boardman, OH 44512 | 2018-04-24 |
| 1528574910 | Herman Frank IIi | Licensed Practical Nurse | 920 Boardman Canfield Road, Boardman, OH 44512 | 2017-12-20 |
| 1730601980 | Stephanie Ann Mathews | Nurse Practitioner | 7600 Southern Blvd #1, Boardman, OH 44512 | 2017-07-10 |
| 1417485079 | Telka Ghobadi | Family Medicine | 8423 Market St., Suite 101, Boardman, OH 44512 | 2017-05-26 |
| 1356797534 | Haroon Hussain Syed | Student in an Organized Health Care Education/Training Program | 8423 Market Street, St. Elizabeth Boardman Hospital, Boardman, OH 44512 | 2016-05-06 |
| Find all providers in zip 44512 | ||||
| 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 |
|---|---|---|---|---|
| 1417128380 | Alexis Marie Smith | Radiology | 7177 Struthers Rd, Youngstown, OH 44514-2270 | 2008-03-18 |
| 1447315619 | Vikram A Raval | Radiology | 7250 West Blvd, Youngstown, OH 44512-4346 | 2006-12-27 |
| 1710920491 | Mri Cooperative Co. | Radiology | 6414 Market Street, Youngstown, OH 44512-3457 | 2006-06-13 |
| 1487621785 | Diagnostic Medical X Ra | Radiology | 8390 Tod Ave, Youngstown, OH 44512-6366 | 2006-03-06 |
| 1396733499 | Medical Imaging Network LLC | Radiology | 4300 Belmont Ave, Youngstown, OH 44505-1084 | 2005-10-12 |
| 1811996135 | Radiology Consultants Inc | Radiology | 7623 Market St, Youngstown, OH 44512-6054 | 2005-07-19 |
| 1891794129 | Asad Azarvan | Radiology | 250 Debartolo Pl, Youngstown, OH 44512-7004 | 2005-07-19 |
| 1528687381 | Alexis Lynn De La Cruz | Radiology | 1044 Belmont Ave, Youngstown, OH 44504-1006 | 2020-04-13 |
| 1033672506 | Anjali Singh | Radiology | 1044 Belmont Ave, Youngstown, OH 44504-1006 | 2019-04-10 |
| 1376004606 | Colin Marshall | Radiology | 1044 Belmont Ave, Youngstown, OH 44504-1006 | 2019-03-28 |
| Find all providers in YOUNGSTOWN | ||||
| City | YOUNGSTOWN |
| Zip Code | 44512 |
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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.