NPIMap

Organization Active NPI

Interventional Procedures Group LTD

Doing business as Center for Diagnostic Imaging

  • Diagnostic Radiology Physician
  • Wauwatosa, WI
National Provider Identifier
1003869140
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
INTERVENTIONAL PROCEDURES GROUP LTD
Doing business as
Center for Diagnostic Imaging
Practice address
2445 North Mayfair Road
Wauwatosa, WI 53226
Phone
(414) 774-7226
Fax
(414) 774-6004
NPI assigned
May 18, 2006
Last updated
Apr 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Authorized official

Name
Donald D Jacobsen
Title
Officer on the Board Secretary
Phone
(952) 543-6500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X
Interventional Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

2445 North Mayfair Road
Wauwatosa, WI 53226

Mailing address

5775 Wayzata Blvd.
Suite 400
St. Louis Park, MN 55416
Phone (952) 542-8553

Other names 1

  • Center for Diagnostic Imaging Doing business as

National Provider Directory

National Provider Directory

Locations

2547 Sun Vly Dr
Ste 100
Delafield, WI 53018
Phone (262) 646-5199

2547 Sun Vly Dr Ste 100
Delafield, WI 53018
Phone (262) 646-5199

1340 W Towne Square Rd
Ste A
Mequon, WI 53092
Phone (262) 240-7226

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1003869140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD.",
            "address_2": "SUITE 400",
            "city": "ST. LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "952-542-8553",
            "fax_number": "952-513-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 NORTH MAYFAIR ROAD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-774-7226",
            "fax_number": "414-774-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL PROCEDURES GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "JACOBSEN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICER ON THE BOARD SECRETARY",
        "authorized_official_telephone_number": "952-543-6500"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Diagnostic Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.