Rad One Inc

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

License

CRT8522 Issued in FL

Legal business name

RAD ONE INC

Practice address

12462 Krome Ave
Port Charlotte, FL 33981-1327

Phone

(941) 815-1103

Fax

(239) 541-5445

NPI assigned

Jul 1, 2011

Last updated

Jul 1, 2011By 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

David Courson, MS.RTR.

Title

Partner

Phone

(941) 815-1103

Specialties & licenses 3

Addresses

Other identifiers 2

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1093002776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12462 KROME AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339811327",
            "telephone_number": "941-815-1103",
            "fax_number": "239-541-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12462 KROME AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339811327",
            "telephone_number": "941-815-1103",
            "fax_number": "239-541-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAD ONE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "COURSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "941-815-1103",
        "authorized_official_credential": "MS.RTR."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "FL",
            "license": "CRT39038",
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "FL",
            "license": "CRT8522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESALE TAX ID",
            "identifier": "1880149214156",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION ID",
            "identifier": "P02000132080",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy E Quillen, PHARM.D.
• Elias Rilloraza Quintos, M.D.
• Olivia M Quintos, PT
• Aslam Hyder Qureshi
• Nicole Jacclyn Raczka, DPT
• Travis Rademaker, CRNA
• Radiology Regional Center, PA
• John B Rafacz, CRNA
• Priscilla Raffi
• Brooke Raider, LMHC

• Radiologic Technologist in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Radiologic Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.