NPIMap

Organization Active NPI

Moberly Radiology & Imaging I, LLC

  • Radiology Clinic/Center
  • Moberly, MO
National Provider Identifier
1093854358
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MOBERLY RADIOLOGY & IMAGING I, LLC
Practice address
1509 Union Ave
Moberly, MO 65270-9407
Phone
(660) 263-8986
Fax
(660) 263-8993
NPI assigned
Feb 5, 2007
Last updated
Oct 3, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Authorized official

Name
Mrs. Emily McKeen
Title
Billing Manager
Phone
(660) 263-8986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X NU Primary

Addresses

Primary practice location

1509 Union Ave
Moberly, MO 65270-9407

Mailing address

1509 Union Ave
PO Box 188
Moberly, MO 65270-9407
Phone (660) 263-8986

Other identifiers 1

IdentifierTypeStateIssuer
714906906MedicaidMO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1093854358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 UNION AVE",
            "address_2": "PO BOX 188",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709407",
            "telephone_number": "660-263-8986",
            "fax_number": "660-263-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 UNION AVE",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709407",
            "telephone_number": "660-263-8986",
            "fax_number": "660-263-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBERLY RADIOLOGY & IMAGING I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "MCKEEN",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "660-263-8986",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "714906906",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moberly, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.