Jacksonville Mobile Imaging Services Inc

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

HCC3853 Issued in FL

Legal business name

JACKSONVILLE MOBILE IMAGING SERVICES INC

Practice address

4237 Salisbury Rd
Suite 306
Jacksonville, FL 32216-8029

Phone

(904) 296-0353

Fax

(904) 296-9403

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David Johnson, RT.,NMT

Title

President

Phone

(904) 296-0353

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1043233380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4237 SALISBURY RD",
            "address_2": "SUITE 306",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168029",
            "telephone_number": "904-296-0353",
            "fax_number": "904-296-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4237 SALISBURY RD",
            "address_2": "SUITE 306",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168029",
            "telephone_number": "904-296-0353",
            "fax_number": "904-296-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE MOBILE IMAGING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-296-0353",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RT.,NMT"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "FL",
            "license": "HCC3853",
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "FL",
            "license": "HCC3853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "PIN#1365 102533",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRINCIPAL",
            "identifier": "606011",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "630000562",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physiological Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.