FORT PAYNE MRI LLC (NPI# 1730145988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730145988 |
| Entity Type | Organization |
| Organization Name | FORT PAYNE MRI LLC |
| Practice Address |
1110 Glenn Blvd Sw Suite 100 Fort Payne AL 35967-8486 |
| Practice Telephone | 2568459402 |
| Practice Fax Number | 2568459410 |
| Mailing Telephone | 2568459402 |
| Mailing Fax Number | 2568459410 |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2008-02-22 |
| Authorized Official Name | JAMES W. HOLMES (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 3372919161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 051557560 | 05 |
| Street Address |
1110 GLENN BLVD SW SUITE 100 |
| City | FORT PAYNE |
| State | AL |
| Zip Code | 35967-8486 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073086922 | Ft Payne Careplus, LLC | Clinic/Center | 3000 Gault Ave North, Ft Payne, AL 35967 | 2019-01-03 |
| 1851739023 | Marlon Chad Williamson | Emergency Medicine | 617 Gault Ave N, Fort Payne, AL 35967 | 2013-06-11 |
| 1447552401 | Karole Kelley Ohme | Counselor | 216 Gault Avenue N, Relationship Clinic, Fort Payne, AL 35967 | 2010-11-24 |
| 1720112014 | Dekalb County Mr Board | Case Management | 117 First St Nw, Fort Payne, AL 35967 | 2007-03-16 |
| 1447275490 | Glynn Whiddon Odom | Nurse Anesthetist, Certified Registered | 200 Medical Center Drive, Fort Payne, AL 35967 | 2006-07-12 |
| 1477521698 | Michael Ray Parker | Optometrist | 900 Gault Ave S, Fort Payne, AL 35967 | 2006-03-14 |
| 1144204843 | Dale Ray Stierwalt | Family Medicine | 1618 Gault Ave. N., Fort Payne, AL 35967 | 2005-12-06 |
| 1417951112 | Barton Drake Ibsen | Physical Therapist | 121 Drinkard Dr, Fort Payne, AL 35967 | 2005-06-09 |
| 1407363146 | Tyson Scott Rainer | Nurse Practitioner | 1040 Glenn Blvd Sw, Fort Payne, AL 35967 | 2018-01-03 |
| 1801336599 | Caitlin Kirby | Massage Therapist | 216 Gault Ave N, Fort Payne, AL 35967 | 2017-03-01 |
| Find all providers in zip 35967 | ||||
| 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 |
|---|---|---|---|---|
| 1326169343 | Dekalb Radiology | Radiology | 200 Medical Center Drive, Fort Payne, AL 35968 | 2007-04-03 |
| 1710030689 | Bradley M Cochran | Radiology | 200 Medical Center Drive, Fort Payne, AL 35968 | 2007-01-22 |
| 1891848784 | Dekalb Radiologist Group, LLC | Radiology | 200 Medical Center Drive, Fort Payne, AL 35968 | 2007-01-22 |
| 1467451435 | Robert Charles Mills | Radiology | 200 Medical Center Dr, Fort Payne, AL 35968 | 2005-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871190256 | Charles M Thorn | Radiology | 204 Debbie Dr, Deatsville, AL 36022-2567 | 2020-10-08 |
| 1184264152 | Locus Center, LLC | Radiology | 3064 Lorna Rd Ste E, Vestavia Hills, AL 35216-4529 | 2020-01-08 |
| 1497241756 | Anurag Chahal | Radiology | Department of Radiology 619 19th Street South, Birmingham, AL 35249-0001 | 2018-07-10 |
| 1427595511 | Lemak Sports Medicine LLC | Radiology | 2215 Decatur Hwy Ste 117, Gardendale, AL 35071-2384 | 2017-01-26 |
| 1346782307 | Birmingham Physicians Radiology Pllc | Radiology | 3425 Colonnade Pkwy, Birmingham, AL 35243-2356 | 2016-11-08 |
| 1558720953 | Brookwood Baptist Imaging, LLC | Radiology | 7131 Cahaba Valley Rd. Suite 101, Hoover, AL 35242 | 2016-02-15 |
| 1255799847 | Central Alabama Diagnostics LLC | Radiology | 2715 Legends Pkwy, Prattville, AL 36066-7755 | 2016-02-10 |
| 1932579042 | Arthur Mazyck | Radiology | 2159 Woodley Road, Montgomery, AL 36111 | 2015-10-01 |
| 1528445145 | Dothan Diagnostic Imaging Radiology, Pllc | Radiology | 217 Graceland Dr Ste 4, Dothan, AL 36305-7376 | 2015-05-04 |
| 1194111245 | Darrel Alexander Ceballos | Radiology | 619 19th Street South Jt N382, Birmingham, AL 35294-2238 | 2015-04-15 |
| Find all providers with the same taxonomy | ||||
| City | FORT PAYNE |
| Zip Code | 35967 |
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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.