Tackett-Holschuh Radiology, Inc

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

TACKETT-HOLSCHUH RADIOLOGY, INC

Practice address

411 Central Avenue
Suite 1
South Williamson, KY 41503

Phone

(606) 237-6300

Fax

(606) 237-7444

NPI assigned

Oct 12, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Donald R Tackett Jr.

Title

Owner/President

Phone

(606) 237-6300

Specialties & licenses 11

Addresses

Other names 1

• Mingo-Pike Radiology Doing business as

Tax ID family

Elite Rehab and Weightloss2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Elite Rehab and Weightloss

  • Chiropractor
  • Morrow, GA
  • NPI 1083074090
  NPD tax ID

Locations

Practitioners 1

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

• Bapuji Narra, M.D

  • Diagnostic Radiology Physician
  • South Williamson, KY
  • NPI 1275598625
  NPD (past)

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444608000000",
    "number": "1053782482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 CENTRAL AVENUE",
            "address_2": "SUITE 1",
            "city": "SOUTH WILLIAMSON",
            "state": "KY",
            "postal_code": "41503",
            "telephone_number": "606-237-6300",
            "fax_number": "606-237-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CENTRAL AVENUE",
            "address_2": "SUITE 1",
            "city": "SOUTH WILLIAMSON",
            "state": "KY",
            "postal_code": "41503",
            "telephone_number": "606-237-6300",
            "fax_number": "606-237-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TACKETT-HOLSCHUH RADIOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A",
        "authorized_official_last_name": "TACKETT",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "606-237-6300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2085D0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471B0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Bone Densitometry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471C3401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471M2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Mammography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mingo-Pike Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caitlyn Smith, APRN
• Gary Thomas Smith, D.O.
• Julie Smith, OTR/L
• James Arlin Stanley, APRN
• Stay Well Chiropractic, Inc.
• Phillip Thacker, BA
• Nona Melissa Thornsbury, BA
• Todd N Tom, MD
• Total Renal Care Inc
• Bryan-Lee Austin Trent

• Magnetic Resonance Imaging (MRI) Clinic/Center in South Williamson, KY
• Providers in South Williamson, KY by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Kentucky

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