Organization Active NPI

Sulphur Springs Imaging Center LTD

  • Diagnostic Radiology Physician
  • Sulphur Springs, TX
National Provider Identifier
1063293868
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SULPHUR SPRINGS IMAGING CENTER LTD
Practice address
109 Medical Cir
Sulphur Springs, TX 75482-2138
Phone
(903) 919-5220
NPI assigned
Oct 9, 2023
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Stephanie Spann, MDNPI 1790172815
Title
Authorized Official
Phone
(903) 900-8689

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

109 Medical Cir
Sulphur Springs, TX 75482-2138

Mailing address

PO Box 100
Paris, TX 75461-0100
Phone (903) 919-5220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240805001805 TX Part B Supplier - Clinic/Group Practice 8123565421 Receives reassigned benefits from 7 practitioners
Practice locations: Dallas, TX; Irving, TX; Longview, TX; McKinney, TX; Powderly, TX; Sulphur Springs, TX

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
45D2106040Sulphur Springs Imaging Center109 Medical Circle, Sulphur Springs, TX 75482Certificate of waiverDec 8, 2027

National Provider Directory

National Provider Directory

Locations

1010 N 6th St
Longview, TX 75601
Phone (903) 757-9596

Practitioners & affiliated clinicians

Practitioners 8

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": "1696809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1063293868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754610100",
            "telephone_number": "903-919-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 MEDICAL CIR",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822138",
            "telephone_number": "903-919-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULPHUR SPRINGS IMAGING CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-09",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "SPANN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "903-900-8689",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur Springs, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.