MOBILE MEDICAL IMAGING LLC (NPI# 1619158862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619158862 |
| Entity Type | Organization |
| Organization Name | MOBILE MEDICAL IMAGING LLC |
| Practice Address |
1127 Old Rd Chapin SC 29036-8512 |
| Practice Telephone | 8039172988 |
| Practice Fax Number | 8037810077 |
| Mailing Telephone | 8039172988 |
| Mailing Fax Number | 8037810077 |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2016-03-23 |
| Authorized Official Name | MR. RUSSELL STEVEN JACOBUS (OWNER) |
| Authorized Official Telephone | 8039172988 |
| Authorized Official Credential | RT(ARRT) |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 498018 | 05 | |
| SC | TRAVELERS MEDICARE RAILRO | 300005574 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902137904 | Mobile Medical Imaging LLC | Clinical Medical Laboratory | 7907 Founders Cir, Naples, FL 34104-5341 | 2010-01-15 |
| Street Address |
1127 OLD RD |
| City | CHAPIN |
| State | SC |
| Zip Code | 29036-8512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841326287 | Russell Steven Jacobus | Radiologic Technologist | 1127 Old Rd, Chapin, SC 29036-8512 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295381291 | Palmetto Bone and Joint | Pain Medicine | 104 Ellett Road, Chapin, SC 29036 | 2019-08-15 |
| 1578028270 | Chapin Smiles Dentistry, PC | Dentist | 1221 Chapin Rd., Suite A, Chapin, SC 29036 | 2019-02-06 |
| 1467934810 | Cornerstone Alliance, LLC | Pharmacy | 105 Snapdragon Court Suite A, Chapin, SC 29036 | 2018-09-02 |
| 1922499011 | Chapin Oral and Maxillofacial Surgery, LLC | Dentist | 112 St. Peter's Church Road, Chapin, SC 29036 | 2015-02-10 |
| 1861892077 | Whitney Crowley | Pharmacist | 1419 Chapin Rd, Chapin, SC 29036 | 2014-08-26 |
| 1417370180 | Backdoc, LLC | Chiropractor | 510 Columbia Avenue, Chapin, SC 29036 | 2014-01-30 |
| 1720425895 | Amanda C Harrington | Registered Nurse | 11629 Broad River Road, Chapin, SC 29036 | 2013-05-30 |
| 1396064382 | Palmetto Pediatric Ot, LLC | Clinic/Center | 2427 Old Lexington Highway, Chapin, SC 29036 | 2010-05-31 |
| 1801036959 | Nelson Chiropractic Care LLC. | Preferred Provider Organization | 1402 Chapin Rd., Chapin, SC 29036 | 2009-03-03 |
| 1700044658 | Dieter Karl Bartschat | Psychiatry & Neurology | 863 Willow Cove Rd, Chapin, SC 29036 | 2008-05-28 |
| Find all providers in zip 29036 | ||||
| Taxonomy Code | 335V00000X |
| Grouping | Suppliers |
| Classification | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: title and definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225681562 | Pdi Health Sc LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 170 Meeting St Ste 110, Charleston, SC 29401-3178 | 2019-07-16 |
| 1154832244 | Clearpath Medical | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2607 Woodruff Rd Ste E-525, Simpsonville, SC 29681-4803 | 2017-10-17 |
| 1841661014 | South Carolina Mobile Imaging | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 13 Red Squirrel Ln, Pawleys Island, SC 29585-5239 | 2015-10-14 |
| 1992141717 | Shoreline Imaging | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 910 Gypsy Ln, Mc Clellanville, SC 29458-9733 | 2013-05-20 |
| 1578818704 | Cardio Vascular Imagery LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 118 Sherborne Dr, Spartanburg, SC 29307-2941 | 2012-07-13 |
| 1245590140 | Source Diagnostics of South Carolina, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2701 S Ocean Blvd, Unit 1831, North Myrtle Beach, SC 29582-4641 | 2012-05-24 |
| 1689842932 | Winyah Ancillaries, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 21-d Professional Lane, Pawleys Island, SC 29585 | 2008-02-20 |
| 1003975343 | Mobile Tech, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 111 Harbor Drive, Columbia, SC 29229 | 2006-12-06 |
| 1790731156 | Winyah Diagnostics Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 21d Professional Dr, Pawleys Island, SC 29585 | 2006-05-26 |
| 1043297088 | Mobile Radiology & Ekg of Carolina, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1310 Haviland Cir, Columbia, SC 29210-4030 | 2005-12-30 |
| 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.