NPIMap

Organization Active NPI

Diagnostic Imaging Associates LTD

  • Diagnostic Radiology Physician
  • Chesterfield, MO
National Provider Identifier
1033142146
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DIAGNOSTIC IMAGING ASSOCIATES LTD
Practice address
232 S Woods Mill Rd
Chesterfield, MO 63017-3406
Phone
(314) 434-1500
Fax
(314) 548-4748
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Authorized official

Name
Jeanie Summers
Title
Credentialing
Phone
(314) 471-8323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

232 S Woods Mill Rd
Chesterfield, MO 63017-3406

Mailing address

13209 Corporate Exchange Dr
Bridgeton, MO 63044-3721
Phone (314) 471-8323

Other identifiers 1

IdentifierTypeStateIssuer
711811208MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000118 MO Part B Supplier - Clinic/Group Practice 9638064942 Receives reassigned benefits from 34 practitioners
Practice locations: Ellisville, MO; St Louis, MO; O Fallon, MO; Frontenac, MO; Creve Coeur, MO; Chesterfield, MO

National Provider Directory

National Provider Directory

Locations

15505 Manchester Rd
Ballwin, MO 63011
Phone (636) 256-2588

13209 Corporate Exchange Dr
Bridgeton, MO 63044

425 S Woods Mill Rd
Ste 125
Chesterfield, MO 63017

450 N New Ballas Rd
Ste 250
Saint Louis, MO 63141
Phone (314) 567-4449

10333 Clayton Rd
Saint Louis, MO 63131
Phone (314) 370-2737

16455 Village Plaza View Dr
Wildwood, MO 63011

Practitioners & affiliated clinicians

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1033142146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13209 CORPORATE EXCHANGE DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630443721",
            "telephone_number": "314-471-8323",
            "fax_number": "314-548-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 S WOODS MILL RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173406",
            "telephone_number": "314-434-1500",
            "fax_number": "314-548-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC IMAGING ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "JEANIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "314-471-8323"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "711811208",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.