NPIMap

Organization Active NPI

Appomattox Imaging LLC

  • Radiology Clinic/Center
  • Colonial Heights, VA
National Provider Identifier
1073713855
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
APPOMATTOX IMAGING LLC
Practice address
930 South Ave
Suite 101
Colonial Heights, VA 23834-3621
Phone
(804) 524-2340
Fax
(804) 524-2340
NPI assigned
Jul 20, 2007
Last updated
Jan 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Mr. William Lunn
Title
Vice President
Phone
(804) 267-2958

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary
Diagnostic Ultrasound Physician 2085U0001X

Addresses

Primary practice location

930 South Ave
Suite 101
Colonial Heights, VA 23834-3621

Mailing address

930 South Ave Ste 1
Colonial Heights, VA 23834-3620
Phone (804) 524-2340

Other identifiers 1

IdentifierTypeStateIssuer
1073713855MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250820003267 VA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2567546575 Practice locations: Colonial Heights, VA

National Provider Directory

National Provider Directory

Member of 2

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

Locations

930 South Ave
Ste 1
Colonial Hgts, VA 23834
Phone (804) 524-2340

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1073713855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 SOUTH AVE STE 1",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238343620",
            "telephone_number": "804-524-2340",
            "fax_number": "804-524-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 SOUTH AVE",
            "address_2": "SUITE 101",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238343621",
            "telephone_number": "804-524-2340",
            "fax_number": "804-524-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPOMATTOX IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "LUNN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "804-267-2958",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073713855",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.