Luis F Gonzalez, III, MD, PC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

LUIS F GONZALEZ, III, MD, PC

Doing business as

Champlain Valley Open MRI

Practice address

118 Consumer SQ
Plattsburgh, NY 12901-6507

Phone

(518) 562-3650

Fax

(518) 562-3801

NPI assigned

May 23, 2005

Last updated

Jun 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Michelle Douglas

Title

Credentialing Manager

Phone

(502) 477-1815

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Champlain Valley Open MRI Doing business as

Locations

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1073516126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CONSUMER SQ",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016507",
            "telephone_number": "518-562-3650",
            "fax_number": "518-562-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 CONSUMER SQ",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016507",
            "telephone_number": "518-562-3650",
            "fax_number": "518-562-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS F GONZALEZ, III, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "502-477-1815",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1718890",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champlain Valley Open MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dennis C Lu, MD
• Jady Keslere Lubin, MD
• Ruth Lucas, RN
• Victor Werner Ludewig, MD
• Leta Byrne Luguri
• Julie Sona Lumingu, MD
• Sherod M. Luscombe, LCSW
• Richard Frank Lutinski, D.O.
• Karla Lyon, RN
• Glenn P Lyons, P.A.

• Magnetic Resonance Imaging (MRI) Clinic/Center in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.