Childersburg Diagnostic Imaging, LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

11948 Issued in AL

Legal business name

CHILDERSBURG DIAGNOSTIC IMAGING, LLC

Practice address

34011 US Highway 280
Childersburg, AL 35044-2128

Phone

(256) 378-3313

NPI assigned

Feb 8, 2008

Organization subpart

No

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

Authorized official

Name

Michael T Bice

Title

Administrator

Phone

(256) 378-3313

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1013195254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 349",
            "city": "CHILDERSBURG",
            "state": "AL",
            "postal_code": "350440349",
            "telephone_number": "256-378-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34011 US HIGHWAY 280",
            "city": "CHILDERSBURG",
            "state": "AL",
            "postal_code": "350442128",
            "telephone_number": "256-378-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDERSBURG DIAGNOSTIC IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-08",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "BICE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "256-378-3313"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "AL",
            "license": "11948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atia Healthcare Professionals
• Birmingham Vamc
• John W Bowers, MD
• Cynthia R Brown, L.H.I.S.
• Norman Donald Chambers, M.D.
• Childersburg Diagnostic Imaging, LLC
• Childersburg Family Dental
• Childersburg GR Dental, LLC
• City of Childersburg
• Wendy White Cleveland, RPH

• Physiological Laboratory in Childersburg, AL
• Providers in Childersburg, AL by specialty
• Physiological Laboratory in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.