Active NPI
St Vincent Northwest Radiology LLC
- Diagnostic Radiology Physician
- Fishers, IN
National Provider Identifier
1114978350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- ST VINCENT NORTHWEST RADIOLOGY LLC
- Practice address
- 11201 USA Pkwy
Suite 140
Fishers, IN 46037-9202 - Phone
- (317) 913-8910
- NPI assigned
- May 12, 2006
- Last updated
- Jun 18, 2009
- 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
- Linda A Wilgus
- Title
- Executive Director
- Phone
- (317) 328-5050
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
11201 USA Pkwy
Suite 140
Fishers, IN 46037-9202
Mailing address
5901 Technology Center Dr
Indianapolis, IN 46278-6013
Phone (317) 328-5050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200182900 | Medicaid | IN |
National Provider Directory
National Provider DirectoryLocations
13590 Collections Ctr
Chicago, IL 60693
11201 USA Pkwy
#140
Fishers, IN 46037
Phone (317) 913-8910
Practitioners & affiliated clinicians
Practitioners 49
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1245283200000",
"number": "1114978350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5901 TECHNOLOGY CENTER DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462786013",
"telephone_number": "317-328-5050",
"fax_number": "317-715-9965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11201 USA PKWY",
"address_2": "SUITE 140",
"city": "FISHERS",
"state": "IN",
"postal_code": "460379202",
"telephone_number": "317-913-8910"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST VINCENT NORTHWEST RADIOLOGY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-12",
"last_updated": "2009-06-18",
"status": "A",
"authorized_official_last_name": "WILGUS",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "317-328-5050"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200182900",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fishers, IN
- Mariss L Sraders, M.D.
- Sean J Sreniawski, PA
- Heather Srncik
- SS Wellness PC
- St Vincent Fishers Hospital Inc (Ascension St Vincent Fishers)
- St. Vincent Anderson Regional Hospital, Inc. (St. Vincent Home Medical)
- St. Vincent Hospital
- St. Vincent Medical Group, Inc. (Ascension Medical Group St. Vincent)
- St. Vincent Medical Group, Inc. (Ascension Medical Group St. Vincent)
- St. Vincent Physician Network, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.