Organization Active NPI

Medical Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Lumberton, NC
National Provider Identifier
1003331786
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MEDICAL IMAGING CENTER, LLC
Practice address
588 Bailey Rd
Lumberton, NC 28358-2455
Phone
(910) 221-2500
NPI assigned
Aug 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brandi Henry
Title
Executive Director
Phone
(910) 221-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

588 Bailey Rd
Lumberton, NC 28358-2455

Mailing address

3186 Village Dr Ste 101
Fayetteville, NC 28304-3979
Phone (910) 221-2500

Other identifiers 1

IdentifierTypeStateIssuer
5912303MedicaidNC

Other names 1

  • Valley Regional Imaging Doing business as

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1003331786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3186 VILLAGE DR STE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043979",
            "telephone_number": "910-221-2500",
            "fax_number": "910-323-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 BAILEY RD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582455",
            "telephone_number": "910-221-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL IMAGING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-221-2500"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5912303",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Regional Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.