Active NPI
Medfund LLC
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Augusta, GA
National Provider Identifier
1073516134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Legal business name
- MEDFUND LLC
- Practice address
- 2803 Wrightsboro Rd
Ste 18
Augusta, GA 30909-3917 - Phone
- (706) 729-9800
- Fax
- (706) 729-8980
- NPI assigned
- May 23, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Martin J Kern
- Title
- Senior Vice President
- Phone
- (941) 925-3490
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Magnetic Resonance Imaging (MRI) Clinic/Center | 261QM1200X | Primary |
Addresses
Primary practice location
2803 Wrightsboro Rd
Ste 18
Augusta, GA 30909-3917
Mailing address
240 N Washington Blvd
Sarasota, FL 34236-5945
Phone (941) 925-3490
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52070692 | Other | BCBS PROVIDER # | |
| 7487068 | Other | GA | AETNA PROVIDER # |
| SL0069 | Medicaid | SC |
Other names 1
- Horizon Augusta LLC
National Provider Directory
National Provider DirectoryLocations
2803 Wrightsboro Rd
Ste 18
Augusta, GA 30909
Phone (706) 729-9800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1073516134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 N WASHINGTON BLVD",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342365945",
"telephone_number": "941-925-3490",
"fax_number": "941-953-4452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2803 WRIGHTSBORO RD",
"address_2": "STE 18",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309093917",
"telephone_number": "706-729-9800",
"fax_number": "706-729-8980"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDFUND LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-05-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KERN",
"authorized_official_first_name": "MARTIN",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
"authorized_official_telephone_number": "941-925-3490",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QM1200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER #",
"identifier": "52070692",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER #",
"identifier": "7487068",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SL0069",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Horizon Augusta LLC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Augusta, GA
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.