SPECIALIZED RADIOLOGY SERVICES INC (NPI# 1588924013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588924013 |
| Entity Type | Organization |
| Organization Name | SPECIALIZED RADIOLOGY SERVICES INC |
| Other Organization Name | PEDIATRIC RADIOLOGY OF AMERICA |
| Practice Address |
2840 Electric Rd Suite 205-a Roanoke VA 24018-3551 |
| Practice Telephone | 5409044088 |
| Mailing Telephone | 5409044088 |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2012-05-17 |
| Authorized Official Name | SHEHNAZ PANCHOLI (CEO) |
| Authorized Official Telephone | 6178680042 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
VA | Allopathic & Osteopathic Physicians | |
| Y | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
VA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PEDIATRIC RADIOLOGY OF AMERICA | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Specialized Radiology Services Inc. | 2840 Electric Road, Ste 205a, Roanoke, Virginia 24018 |
| Street Address |
2840 ELECTRIC RD SUITE 205-A |
| City | ROANOKE |
| State | VA |
| Zip Code | 24018-3551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508008913 | Louise Godine | Radiology | 2840 Electric Rd, Suite 205 A, Roanoke, VA 24018-3551 | 2009-03-31 |
| 1336503804 | Christina Vaughn | Counselor | 2840 Electric Rd, Suite 200, Roanoke, VA 24018-3551 | 2016-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140253 | Luz Dione Carr | Nurse Practitioner | 1934 Maple Leaf Drive, Roanoke, VA 24018 | 2019-05-21 |
| 1467926527 | Embrace Foster Care, LLC | Foster Care Agency | 3912 Electric Road, Building C, Roanoke, VA 24018 | 2019-01-11 |
| 1174005417 | Roanoke Valley Ent & Allergy PC | Otolaryngology | 2154 Mcvitty Rd, Second Floor, Roanoke, VA 24018 | 2018-09-04 |
| 1265928535 | Jane Willis Warner | Behavior Technician | 3243 Electric Road Building E Suite 1b, Roanoke, VA 24018 | 2018-07-10 |
| 1821584640 | Anchor To Hope Counseling LLC | Counselor | 4370 Starkey Rd Ste 4c-1, Roanoke, VA 24018 | 2018-07-04 |
| 1164938619 | Aurora Domangue | Behavior Technician | 3243 Electric Road, Building E Suite 1b, Roanoke, VA 24018 | 2017-12-20 |
| 1376059089 | Maggie Marie Ridgeway | Behavior Technician | 3243 Electric Rd., Building E Suite 1b, Roanoke, VA 24018 | 2017-12-18 |
| 1700301850 | Nicole Graboski | Speech-Language Pathologist | 4920 Woodmar Drive Sw, Roanoke, VA 24018 | 2017-08-10 |
| 1891215893 | Kimberly Anne Rosenberger | Occupational Therapy Assistant | 2772 Hillbrook Dr., Roanoke, VA 24018 | 2017-06-21 |
| 1083158950 | Encompass Home Health of Roanoke, LLC | Home Health | 5115 Bernard Drive, Suite 205, Roanoke, VA 24018 | 2016-12-13 |
| Find all providers in zip 24018 | ||||
| Taxonomy Code | 2085P0229X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Pediatric Radiology |
| A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood. |
| 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 |
|---|---|---|---|---|
| 1720277353 | Margery Manuli | Radiology | 559 S Poes Rd, Amissville, VA 20106-4007 | 2007-10-19 |
| 1952622516 | Nicholas William Digeorge | Radiology | 620 John Paul Jones Circle, Department of Radiology, Portsmouth, VA 23708 | 2010-06-17 |
| 1669796389 | Lydia E Kuo-bonde | Radiology | 1215 Lee St Fl 1, Charlottesville, VA 22908-0816 | 2010-03-24 |
| 1891832184 | Scott B. Rader | Radiology | 5544 Greenwich Rd Ste 200, Virginia Beach, VA 23462-6563 | 2007-01-30 |
| 1518015296 | Bennett A. Alford | Radiology | Uva Hospital, Lee Street, 1st Floor, Charlottesville, VA 22908-0001 | 2007-01-08 |
| 1427004571 | Gerry L Reece | Radiology | 2602 Buford Rd, Richmond, VA 23235-3422 | 2006-05-26 |
| 1255386462 | David A May | Radiology | 2602 Buford Rd, Richmond, VA 23235-3422 | 2006-05-24 |
| 1124006747 | Vincent James Mascatello | Radiology | 4001 Fair Ridge Dr, #103, Fair Oaks Imaging Center, Fairfax, VA 22033-2917 | 2006-01-04 |
| 1346226537 | Ronald L King | Radiology | 5544 Greenwich Rd, Ste.200, Virginia Beach, VA 23462-6563 | 2005-12-20 |
| 1689659237 | Susanne Ng Grasso | Radiology | 5544 Greenwich Rd Ste 200, Virginia Beach, VA 23462-6563 | 2005-12-07 |
| Find all providers with the same taxonomy | ||||
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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.