NPIMap

Organization Active NPI

Suncoast Radiology, P.a.

  • Diagnostic Radiology Physician
  • Ormond Beach, FL
National Provider Identifier
1083670871
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SUNCOAST RADIOLOGY, P.A.
Practice address
500 Memorial Circle
Suite B
Ormond Beach, FL 32174-5054
Phone
(386) 673-8040
Fax
(386) 267-0693
NPI assigned
Apr 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Authorized official

Name
Ms. JT Tener
Title
Human Resources/Credentialing
Phone
(386) 673-8040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

500 Memorial Circle
Suite B
Ormond Beach, FL 32174-5054

Mailing address

500 Memorial Circle
Suite B
Ormond Beach, FL 32174-5054
Phone (386) 673-8040

Other identifiers 3

IdentifierTypeStateIssuer
00400OtherFLBCBS GROUP NUMBER
CB5023OtherFLRR MEDICARE ID
CG7286OtherFLRR MEDICARE ID

National Provider Directory

National Provider Directory

Locations

500 Memorial Cir
Ste E
Ormond Beach, FL 32174
Phone (386) 672-5881

483 S Nova Rd
Ormond Beach, FL 32174
Phone (386) 481-6160

500 Memorial Cir
Ste D
Ormond Beach, FL 32174
Phone (386) 672-5881

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1083670871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MEMORIAL CIRCLE",
            "address_2": "SUITE B",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745054",
            "telephone_number": "386-673-8040",
            "fax_number": "386-267-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MEMORIAL CIRCLE",
            "address_2": "SUITE B",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745054",
            "telephone_number": "386-673-8040",
            "fax_number": "386-267-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST RADIOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "TENER",
        "authorized_official_first_name": "JT",
        "authorized_official_title_or_position": "HUMAN RESOURCES/CREDENTIALING",
        "authorized_official_telephone_number": "386-673-8040",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "00400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE ID",
            "identifier": "CB5023",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE ID",
            "identifier": "CG7286",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.