Pediatric Diagnostic Imaging, S.C.

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

23901-020 Issued in WI

Legal business name

PEDIATRIC DIAGNOSTIC IMAGING, S.C.

Practice address

8522 W Capitol Dr
Milwaukee, WI 53222-1827

Phone

(414) 847-1800

Fax

(414) 847-1820

NPI assigned

Aug 12, 2006

Last updated

Mar 11, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert G Wells, M.D.NPI 1376592832

Title

President

Phone

(414) 847-1800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PDI Other name

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Pediatric Diagnostic Imaging, S.C.

  • Radiology Clinic/Center
  • Franklin, WI
  • NPI 1972703031
  NPPES parent name

Practitioners 2

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.

• Robert G Wells, MD

  • Diagnostic Radiology Physician
  • Milwaukee, WI
  • NPI 1376592832
  NPD (past) Authorized official
• Brian E Lundeen, MD

  • Diagnostic Radiology Physician
  • St Francis, WI
  • NPI 1194775445
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236729600000",
    "number": "1033121629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8522 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221827",
            "telephone_number": "414-847-1800",
            "fax_number": "414-847-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8522 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221827",
            "telephone_number": "414-847-1800",
            "fax_number": "414-847-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DIAGNOSTIC IMAGING, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2009-03-11",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-847-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "WI",
            "license": "23901-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21286500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PDI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Susan J Peck, APNP
• Jo Anne Pedersen, MSW
• Jessica Dee Pederson
• Elizabeth Anne Pedi, DPT
• Pediatric and Adult Medicine Associates S.C.
• Pediatric Ear, Nose & Throat Specialists SC
• Pediatric Oral Surgery and General Dental Inc SC
• Pediatric Radiologic Services SC
• Kathrine E Pedriana, PA
• Pedro N Banda MD SC (Capitol Allergy Clinic)

• Radiology Clinic/Center in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Radiology Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; 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.