Southtowne Imaging Center LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

SOUTHTOWNE IMAGING CENTER LLC

Practice address

20 Southtowne Dr
Potosi, MO 63664-5729

Phone

(573) 436-6736

Fax

(573) 436-7321

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Henry Boots

Title

Owner/Manager

Phone

(573) 315-9109

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 1

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

• James Daley Robart Jr., DC

  • Chiropractor
  • Potosi, MO
  • NPI 1003981895
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1104991918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SOUTHTOWNE DR",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636645729",
            "telephone_number": "573-436-6736",
            "fax_number": "573-436-7321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SOUTHTOWNE DR",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636645729",
            "telephone_number": "573-436-6736",
            "fax_number": "573-436-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHTOWNE IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "BOOTS",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "573-315-9109"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP NUMBER",
            "identifier": "269801",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "710002502",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "P00277531",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA NUMBER",
            "identifier": "59787",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rackel Elizabeth Sexton-Alfaro, LCSW
• Simpelo Medi-Spa
• Simpelo Medical Clinic, P.C.
• Rustico V Simpelo, MD
• Brett T Snodgrass, MD
• Matthew Scott Standridge, D.D.S.
• Vonna Suda, EDS
• Bobbi J Summers, LPC
• Gregory Keith Terpstra, DO
• Jeffrey Paul Tindall, DO

• Radiology Clinic/Center in Potosi, MO
• Providers in Potosi, MO by specialty
• Radiology Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.