Active NPI
Mci Diagnostic Center, LLC
- Durable Medical Equipment & Medical Supplies
- Richardson, TX
National Provider Identifier
1114485042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- MCI DIAGNOSTIC CENTER, LLC
- Practice address
- 1155 Kas Dr Ste 180
Richardson, TX 75081-1970 - Phone
- (469) 485-2382
- Fax
- (833) 390-1352
- NPI assigned
- Mar 11, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Colleen Payne
- Title
- Coo
- Phone
- (469) 485-2382
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
1155 Kas Dr Ste 180
Richardson, TX 75081-1970
Mailing address
1155 Kas Dr Ste 180
Richardson, TX 75081-1970
Phone (469) 485-2382
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200031560F | Medicaid | OK |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Dallas | Direct |
National Provider Directory
National Provider Directory- Tax ID family
- Mobile Cardiac Imaging
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Physical Therapy Clinic/Center
- Tulsa, OK
- NPI 1366757866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552262400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1661126400000",
"number": "1114485042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 KAS DR STE 180",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750811970",
"telephone_number": "469-485-2382",
"fax_number": "833-390-1352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 KAS DR STE 180",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750811970",
"telephone_number": "469-485-2382",
"fax_number": "833-390-1352"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCI DIAGNOSTIC CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-11",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A",
"authorized_official_last_name": "PAYNE",
"authorized_official_first_name": "COLLEEN",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "469-485-2382"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200031560F",
"state": "OK"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Dallas",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1155 Kas Dr Ste 180",
"city": "Richardson",
"state": "TX",
"country_code": "US",
"postal_code": "750811970",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.