Organization Active NPI

Medical Imaging North PA

  • Diagnostic Radiology Physician
  • Hibbing, MN
National Provider Identifier
1043338171
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MEDICAL IMAGING NORTH PA
Practice address
2900 E Beltline
Hibbing, MN 55746-4504
Phone
(218) 312-3002
NPI assigned
Mar 27, 2007
Last updated
Nov 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Authorized official

Name
Dr. Daniel Courneya, M.D.NPI 1891896239
Title
President
Phone
(218) 312-3005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary
Vascular & Interventional Radiology Physician 2085R0204X

Addresses

Primary practice location

2900 E Beltline
Hibbing, MN 55746-4504

Mailing address

1200 E 25TH St
Hibbing, MN 55746-3897
Phone (218) 312-3002

Other identifiers 4

IdentifierTypeStateIssuer
69531MEOtherMNBLUE CROSS BLUE SHIELD
782012700MedicaidMN
103198OtherMNUCARE
CD6182OtherMNRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MN, FL, ND, VA5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20050927000261 TX Part B Supplier - Clinic/Group Practice 8628002888 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX
O20080304000582 MN Part B Supplier - Clinic/Group Practice 8628002888 Receives reassigned benefits from 2 practitioners
Practice locations: Roseau, MN; Moose Lake, MN; International Falls, MN; Grand Rapids, MN; Bigfork, MN; Baudette, MN
O20240605003113 FL Part B Supplier - Clinic/Group Practice 8628002888 Receives reassigned benefits from 1 practitioner
Practice locations: Delray Beach, FL
O20240614003564 ND Part B Supplier - Clinic/Group Practice 8628002888 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Forks, ND
O20241203004233 VA Part B Supplier - Clinic/Group Practice 8628002888 Receives reassigned benefits from 1 practitioner
Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory

Locations

115 W Howard St
Hibbing, MN 55746
Phone (218) 262-3315

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1043338171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E 25TH ST",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557463897",
            "telephone_number": "218-312-3002",
            "fax_number": "218-312-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 E BELTLINE",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557464504",
            "telephone_number": "218-312-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL IMAGING NORTH PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "COURNEYA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-312-3005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "69531ME",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "782012700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "103198",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD6182",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hibbing, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.