Active NPI
Open MRI of Coles County LLC
- Magnetic Resonance Imaging (MRI) Internal Medicine Physician
- Mattoon, IL
National Provider Identifier
1013931377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Magnetic Resonance Imaging (MRI) Internal Medicine Physician
- License
- 33724466
- Legal business name
- OPEN MRI OF COLES COUNTY LLC
- Practice address
- 100 Professional Plaza
Ste 1a
Mattoon, IL 61938 - Phone
- (217) 345-0700
- Fax
- (217) 345-0712
- NPI assigned
- Jul 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shanna D Runge, PRESIDENT
- Title
- President Ceo
- Phone
- (217) 345-0700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Magnetic Resonance Imaging (MRI) Internal Medicine Physician | 207RM1200X | 33724466 | IL | Primary |
Addresses
Primary practice location
100 Professional Plaza
Ste 1a
Mattoon, IL 61938
Mailing address
100 Professional Plaza
Ste 1a
Mattoon, IL 61938
Phone (217) 345-0700
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2924965 | Other | CIGNA | |
| 081138 | Other | HMO HEALTH ALLIANCE | |
| 534801 | Other | HEALTHLINK PPO | |
| 01532006 | Other | IL | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider DirectoryLocations
100 Professional Plz
Ste 1A
Mattoon, IL 61938
Phone (217) 345-0700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1013931377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 PROFESSIONAL PLAZA",
"address_2": "STE 1A",
"city": "MATTOON",
"state": "IL",
"postal_code": "61938",
"telephone_number": "217-345-0700",
"fax_number": "217-345-0712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PROFESSIONAL PLAZA",
"address_2": "STE 1A",
"city": "MATTOON",
"state": "IL",
"postal_code": "61938",
"telephone_number": "217-345-0700",
"fax_number": "217-345-0712"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OPEN MRI OF COLES COUNTY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-27",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "RUNGE",
"authorized_official_first_name": "SHANNA",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "PRESIDENT CEO",
"authorized_official_telephone_number": "217-345-0700",
"authorized_official_credential": "PRESIDENT"
},
"taxonomies": [
{
"code": "207RM1200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Magnetic Resonance Imaging (MRI)",
"state": "IL",
"license": "33724466",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2924965",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO HEALTH ALLIANCE",
"identifier": "081138",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK PPO",
"identifier": "534801",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "01532006",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mattoon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.