Organization Active NPI

Medfund LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Augusta, GA
National Provider Identifier
1073516134
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
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

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. Martin J Kern
Title
Senior Vice President
Phone
(941) 925-3490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
52070692OtherBCBS PROVIDER #
7487068OtherGAAETNA PROVIDER #
SL0069MedicaidSC

Other names 1

  • Horizon Augusta LLC Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.