NPIMap

Organization Active NPI

Riverside Imaging LLC

  • Radiology Clinic/Center
  • Riverside, CA
National Provider Identifier
1104818459
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
RIVERSIDE IMAGING LLC
Practice address
4000 14TH St
Suite 109
Riverside, CA 92501-4083
Phone
(951) 276-7500
Fax
(951) 276-7543
NPI assigned
Aug 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Mr. Lavelle Hardin
Title
Coordinator
Phone
(615) 344-8203

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X
Radiology Clinic/Center 261QR0200X Primary
Mammography Clinic/Center 261QR0206X

Addresses

Primary practice location

4000 14TH St
Suite 109
Riverside, CA 92501-4083

Mailing address

4000 14TH St
Suite 109
Riverside, CA 92501-4083
Phone (951) 276-7500

Other identifiers 2

IdentifierTypeStateIssuer
IDTF00710MedicaidCA
P00380860OtherCARR MEDICARE

Other names 1

  • Computerized Diagnostic Imaging Centers - Riverside Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1104818459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 14TH ST",
            "address_2": "SUITE 109",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014083",
            "telephone_number": "951-276-7500",
            "fax_number": "951-276-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 14TH ST",
            "address_2": "SUITE 109",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014083",
            "telephone_number": "951-276-7500",
            "fax_number": "951-276-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "LAVELLE",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "615-344-8203",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IDTF00710",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00380860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Computerized Diagnostic Imaging Centers - Riverside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.