OPEN AND WIDE MRI, LLC (NPI# 1558346148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558346148 |
| Entity Type | Organization |
| Organization Name | OPEN AND WIDE MRI, LLC |
| Practice Address |
3050 Windsor Ct Elkhart IN 46514-5555 |
| Mailing Address |
1732 Momentum Pl Chicago IL 60689-5311 |
| Practice Telephone | 5742669222 |
| Practice Fax Number | 5742669333 |
| Mailing Telephone | 3148218055 |
| Mailing Fax Number | 3148211833 |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RANDY KOSTKA (CEO) |
| Authorized Official Telephone | 5742669222 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471M1202X |
Radiologic Technologist Specialization: Magnetic Resonance Imaging |
20590 | IN | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PHP | 14506 | 01 | |
| MI | 1604490821 | 05 | |
| IN | BCBS | 000000275391 | 01 |
| Street Address |
3050 WINDSOR CT |
| City | ELKHART |
| State | IN |
| Zip Code | 46514-5555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891333522 | Adam Collier | Nurse Anesthetist, Certified Registered | 600 Elkhart Boulvard, Elkhart, IN 46514 | 2019-12-12 |
| 1861034688 | Heart City Health Center, Inc. | Obstetrics & Gynecology | 1545 Cassopolis Street, Elkhart, IN 46514 | 2019-10-14 |
| 1982263398 | Fresenius Medical Care North Elkhart, LLC | Clinic/Center | 801 W Bristol St, Elkhart, IN 46514 | 2019-06-10 |
| 1487118220 | Hellenic Senior Living of Elkhart, LLC | Assisted Living Facility | 2528 Bypass Road, Elkhart, IN 46514 | 2019-01-25 |
| 1922595792 | Anna Cornelia Smith | Nutritionist | 51803 Tall Pines Dr, Elkhart, IN 46514 | 2018-04-17 |
| 1114438496 | Erika Lynn Farrell | Counselor | 3120 Suite B Windsor Court, Elkhart, IN 46514 | 2017-10-13 |
| 1740728948 | Michael Scheretie | Nurse Anesthetist, Certified Registered | 52866 Wildflower Ln, Elkhart, IN 46514 | 2017-02-08 |
| 1821355876 | Marcy Lynn Adams | Nurse Practitioner | 1104 W Bristol St, Elkhart, IN 46514 | 2012-04-16 |
| 1053694265 | Paul A. Price | Pharmacist | 1400 Cassopolis St., Elkhart, IN 46514 | 2011-09-23 |
| 1528362647 | Beacon Medical Group, Inc. | Internal Medicine | 500 Arcade Ave., Suite 400, Elkhart, IN 46514 | 2011-01-04 |
| Find all providers in zip 46514 | ||||
| Taxonomy Code | 2471M1202X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Magnetic Resonance Imaging |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558889840 | Pih Advanced Testing P.C. | Radiologic Technologist | 4078 Pendleton Way, Indianapolis, IN 46226-5224 | 2017-09-06 |
| 1154541753 | Indianapolis Neurosurgical Group | Radiologic Technologist | 1925 N. Capitol Avenue, Indianapolis, IN 46202 | 2007-04-26 |
| 1629099650 | Opensided Mri LLC | Radiologic Technologist | 6401 S East St, Suite C, Indianapolis, IN 46227 | 2006-07-23 |
| 1710914023 | Vertical Plus Mri of America, LLC | Radiologic Technologist | 3838 N Main St, Mishawaka, IN 46545-3110 | 2006-06-26 |
| 1891953477 | George Anthony Gardner | Radiologic Technologist | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2008-05-30 |
| 1861612467 | Indianapolis Neurosurgical Group PC | Radiologic Technologist | 7330 E 82nd St, Indianapolis, IN 46256-1465 | 2007-04-26 |
| 1447312616 | Indianapolis Neurosurgical Group | Radiologic Technologist | 7855 S Emerson Ave, Indianapolis, IN 46237-8668 | 2006-12-14 |
| 1518978766 | Indianapolis Neurosurgical Group | Radiologic Technologist | 10603 N Meridian St, Indianapolis, IN 46290-1055 | 2006-08-11 |
Please comment or provide details below to improve the information on OPEN AND WIDE MRI, 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.