NPIMap

Organization Active NPI

Northside Imaging, LLC

  • Diagnostic Radiology Physician
  • Hudson, FL
National Provider Identifier
1063594679
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTHSIDE IMAGING, LLC
Practice address
14108 Glacier Drive
Hudson, FL 34667
Phone
(727) 861-4490
Fax
(727) 861-4491
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert Samuel Hankins Jr.
Title
Senior Vice President
Phone
(615) 344-2274

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

14108 Glacier Drive
Hudson, FL 34667

Mailing address

14108 Glacier Dr
Hudson, FL 34667-8595
Phone (727) 861-4490

Other names 1

  • Bayonet Point Imaging Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northside Imaging Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

14108 Glacier Dr
Hudson, FL 34667
Phone (727) 761-4490

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063594679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14108 GLACIER DR",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346678595",
            "telephone_number": "727-861-4490",
            "fax_number": "727-861-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14108 GLACIER DRIVE",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "34667",
            "telephone_number": "727-861-4490",
            "fax_number": "727-861-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANKINS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "615-344-2274",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayonet Point Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hudson, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.