OPEN MRI, LLC (NPI# 1801892831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801892831 |
| Entity Type | Organization |
| Organization Name | OPEN MRI, LLC |
| Other Organization Name | CEDAR LAKE MRI |
| Practice Address |
1720c Medical Park Dr Biloxi MS 39532-2131 |
| Mailing Address |
Po Box 789 Ocean Springs MS 39566-0789 |
| Practice Telephone | 2283540251 |
| Practice Fax Number | 2283963550 |
| Mailing Telephone | 2288180563 |
| Mailing Fax Number | 2288180519 |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. RANDALL PENBERG (ADMINISTRATOR) |
| Authorized Official Telephone | 2288180563 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08882814 | 05 |
| Other Name | Type Code |
|---|---|
| Cedar Lake MRI | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770550550 | Open Mri, LLC | Radiology | 5227 Dixie Hwy, Louisville, KY 40216-1758 | 2006-03-01 |
| 1265457030 | Open Mri, LLC | Physiological Laboratory | 14245 Dedeaux Rd, Gulfport, MS 39503-3369 | 2006-07-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | OPEN MRI, LLC | 175 Great Neck Road, Great Neck, Ny 11021 |
| Street Address |
1720C MEDICAL PARK DR |
| City | BILOXI |
| State | MS |
| Zip Code | 39532-2131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407852429 | Shaun W Mckee | Radiology | 1720c Medical Park Dr, Biloxi, MS 39532-2131 | 2005-06-23 |
| 1992078950 | Cedar Lake Open Mri LLC | Radiology | 1720c Medical Park Dr, Biloxi, MS 39532-2131 | 2012-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427693613 | Bloom Mental Health LLC | Nurse Practitioner | 933 Tommy Munro Dr., Suite C, Biloxi, MS 39532 | 2019-11-12 |
| 1003397530 | The National Diabetes & Obesity Research Institute At Tradition, Missi | Dietitian, Registered | 19289 St. Joseph Street, Suite C, Biloxi, MS 39532 | 2018-08-23 |
| 1134588999 | Victoria Leonard Scott | Counselor | 6905 Gregory Dr, Biloxi, MS 39532 | 2016-02-22 |
| 1639552490 | Laura O'keefe | Nurse Practitioner | 1720a Medical Park Dr Ste 150, Biloxi, MS 39532 | 2015-06-29 |
| 1659767150 | D'iberville Home Program LLC | Clinic/Center | 14215 Cook Road, Biloxi, MS 39532 | 2015-04-10 |
| 1467842476 | Alicia Michelle Mcdaniel | Nurse Practitioner | 14209 Cook Rd Suite 200, Biloxi, MS 39532 | 2015-01-28 |
| 1437402393 | Lisa Q. Brown | Occupational Therapist | 680 Bay Cove Drive, Residents At Baycove, Biloxi, MS 39532 | 2012-10-17 |
| 1962759381 | Joshua Shumway | Physical Therapist | 220 Ploesti Dr, Keesler Afb, MS 39532 | 2012-08-06 |
| 1386912483 | Polk's Crossgates Discount Drugs Inc. | Pharmacy | 1845 Popps Ferry Road, Biloxi, MS 39532 | 2011-12-05 |
| 1346566957 | Kerri Lyn Manjarrez | Social Worker | 12304 Tiffany Lane, Biloxi, MS 39532 | 2010-04-08 |
| Find all providers in zip 39532 | ||||
| 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 |
|---|---|---|---|---|
| 1982603262 | Neuro Diagnostics, Inc. | Radiology | 240 Eisenhower Dr, Ste C-5, Biloxi, MS 39531-3654 | 2005-07-19 |
| 1407852429 | Shaun W Mckee | Radiology | 1720c Medical Park Dr, Biloxi, MS 39532-2131 | 2005-06-23 |
| 1407216617 | Mark B. Wall, Md Pa | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2016-03-01 |
| 1932585221 | Biloxi Radiology Pa | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2015-08-10 |
| 1992078950 | Cedar Lake Open Mri LLC | Radiology | 1720c Medical Park Dr, Biloxi, MS 39532-2131 | 2012-02-21 |
| 1831328632 | Mckean Radiology, Pllc | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2009-07-14 |
| 1922273408 | Harrison Hma | Radiology | 180 Debuys Rd, Biloxi, MS 39531-4402 | 2008-04-25 |
| 1194990671 | Biloxi Hma | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2008-04-25 |
| 1447438387 | Medicus Radiology Pllc | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2008-02-02 |
| 1497874309 | South Shore Radiology, LLC | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2007-03-29 |
| Find all providers in BILOXI | ||||
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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.