Organization Active NPI

Orchard Imaging, LLC

  • Radiology Clinic/Center
  • Salem, NH
National Provider Identifier
1063007219
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
ORCHARD IMAGING, LLC
Practice address
19 Keewaydin Dr Ste 2
Salem, NH 03079-4891
Phone
(603) 685-4781
Fax
(603) 458-1426
NPI assigned
Mar 9, 2021
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Ms. Tara Jenkins, R.T.
Title
Chief Operating Officer
Phone
(603) 685-4781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

19 Keewaydin Dr Ste 2
Salem, NH 03079-4891

Mailing address

19 Keewaydin Dr Ste 2
Salem, NH 03079-4891
Phone (603) 685-4781

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220105000148 NH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5092106823 Practice locations: Salem, NH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
30D2328652Orchard Imaging, LLC19 Keewaydin Dr, Ste 2, Salem, NH 03079Certificate of waiverAug 13, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1615248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1063007219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 KEEWAYDIN DR STE 2",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030794891",
            "telephone_number": "603-685-4781",
            "fax_number": "603-458-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 KEEWAYDIN DR STE 2",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030794891",
            "telephone_number": "603-685-4781",
            "fax_number": "603-458-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHARD IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-09",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "603-685-4781",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.T."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.