NPIMap

Organization Active NPI

Premier MRI Services LLC

  • Clinic/Center
  • Annapolis, MD
National Provider Identifier
1023111804
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
M231 Issued in MD
Legal business name
PREMIER MRI SERVICES LLC
Practice address
107 Ridgley Ave
Suite 12
Annapolis, MD 21401
Phone
(410) 267-1780
Fax
(410) 267-1784
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Walter Dubiansky
Title
Ceo President
Phone
(410) 267-1780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X M231 MD Primary

Addresses

Primary practice location

107 Ridgley Ave
Suite 12
Annapolis, MD 21401

Mailing address

107 Ridgley Ave
Suite 12
Annapolis, MD 21401
Phone (410) 267-1780

Other identifiers 2

IdentifierTypeStateIssuer
9398PROtherMDBLUE SHIELD OF MARYLAND
K646OtherDCBLUE SHIELD DC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1023111804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 RIDGLEY AVE",
            "address_2": "SUITE 12",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-267-1780",
            "fax_number": "410-267-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 RIDGLEY AVE",
            "address_2": "SUITE 12",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-267-1780",
            "fax_number": "410-267-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MRI SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "DUBIANSKY",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "410-267-1780"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MD",
            "license": "M231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MARYLAND",
            "identifier": "9398PR",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD DC",
            "identifier": "K646",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.