Advanced Diagnostic Center LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

ADVANCED DIAGNOSTIC CENTER LLC

Practice address

205 Hospital Dr
Suite C
MC Kenzie, TN 38201-1649

Phone

(731) 352-7907

Fax

(731) 352-4459

NPI assigned

Mar 24, 2011

Last updated

Mar 29, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

MCKENZIE MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Mrs. Lisa Kay Page

Title

Credentialing Manager

Phone

(731) 352-7907

Specialties & licenses 1

Addresses

Part of

Gleason Rural Health CL

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1033418447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR",
            "address_2": "SUITE C",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR",
            "address_2": "SUITE C",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DIAGNOSTIC CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCKENZIE MEDICAL CENTER",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "731-352-7907",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Place Called Home
• Mallory Akin, ATC,LAT
• Ambulance Services of McKenzie, Inc. (Carroll County EMS)
• Anna Anderson, OD
• Malissa Anderson, SLP-CCC
• Sylvia Ifeyinwa Anunobi, MD, MSPH, JD

• Radiology Clinic/Center in McKenzie, TN
• Providers in McKenzie, TN by specialty
• Radiology Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.