Organization Active NPI

Charlottesville Radiology

  • Surgery Physician
  • Charlottesville, VA
National Provider Identifier
1063532869
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CHARLOTTESVILLE RADIOLOGY
Practice address
500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone
(434) 654-7000
NPI assigned
Mar 29, 2007
Last updated
Nov 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Authorized official

Name
Ms. Christine Jargowski
Title
Office Manager
Phone
(434) 244-4580

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary
Vascular Surgery Physician 2086S0129X NU

Addresses

Primary practice location

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668

Mailing address

PO Box 197
State College, PA 16804-0197

Other identifiers 1

IdentifierTypeStateIssuer
CB4302OtherVARRMED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040602001497 VA Part B Supplier - Clinic/Group Practice 1557259959 Receives reassigned benefits from 18 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlottesville, VA; Zion Crossroads, VA; Williamsburg, VA; Suffolk, VA; Leesburg, VA; Danville, VA; Ashburn, VA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

29 Jefferson Ct
Zion Crossroads, VA 22942
Phone (434) 654-8900

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": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605052800000",
    "number": "1063532869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 197",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168040197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114668",
            "telephone_number": "434-654-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTESVILLE RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A",
        "authorized_official_last_name": "JARGOWSKI",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "434-244-4580",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMED",
            "identifier": "CB4302",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.