Executive Imaging, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

EXECUTIVE IMAGING, LLC

Practice address

1069 Delaware Ave Ste 104
Marion, OH 43302-6459

Phone

(740) 751-6828

Fax

(740) 751-6829

NPI assigned

Jul 21, 2020

Organization subpart

No

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

Authorized official

Name

Brian D Hempstead

Title

Executive Director

Phone

(740) 387-7200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Marion General Hospital, Inc.

  • Clinical Medical Laboratory
  • Marion, OH
  • NPI 1427494277

  Member Of

  NPD member

Locations

Practitioners 1

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

• Richard W Adams, DO

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1568473627
  NPD

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1073121521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1069 DELAWARE AVE STE 104",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026459",
            "telephone_number": "740-751-6828",
            "fax_number": "740-751-6829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1069 DELAWARE AVE STE 104",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026459",
            "telephone_number": "740-751-6828",
            "fax_number": "740-751-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "HEMPSTEAD",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "740-387-7200"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric P Buck, DDS, Marion, LLC
• Chad Evans
• Crystal Evans
• Korbin James Evans
• Shannon Kay Ewing
• Joanna Linn Failor, D.O.
• Kristen L Faine, LICDC,
• Family Dental of Marion James T Leon DDS Inc
• Family Vision Care of Marion, Inc.
• Jack D Farling, PA-C

• Radiology Clinic/Center in Marion, OH
• Providers in Marion, OH by specialty
• Radiology Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.