Montclair Road Imaging, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

MONTCLAIR ROAD IMAGING, LLC

Practice address

924 Montclair Rd
Suite 108
Birmingham, AL 35213-1211

Phone

(205) 592-4674

Fax

(205) 592-4670

NPI assigned

Jan 30, 2006

Organization subpart

No

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

Authorized official

Name

Traci Brown

Title

Director of Billing

Phone

(706) 256-3450

Specialties & licenses 1

Addresses

Other identifiers 10

Other names 1

• ImageSouth Montclair Road Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Montclair Road Imaging, LLC

  • Radiology Clinic/Center
  • Homewood, AL
  • NPI 1598294688
  NPPES parent name

Practitioners 5

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

• Darin M Brummett, M.D.

  • Vascular & Interventional Radiology Physician
  • Carrollton, GA
  • NPI 1447222476
  NPD (past)
• Daniel Johnston Cranford, D.O.

  • Diagnostic Radiology Physician
  • Cape Girardeau, MO
  • NPI 1497068795
  NPD (past)
• Robert S Hyslop, M.D.

  • Diagnostic Radiology Physician
  • Carrollton, GA
  • NPI 1093868952
  NPD (past)
• Ho Nien Lin, M.D.

  • Diagnostic Radiology Physician
  • Carrollton, GA
  • NPI 1790759165
  NPD (past)
• Sagar Mangu Patel, D.O.

  • Diagnostic Radiology Physician
  • Carrollton, GA
  • NPI 1801186689
  NPD (past)

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1114998192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931108",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311931108",
            "telephone_number": "205-995-9899",
            "fax_number": "205-995-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 MONTCLAIR RD",
            "address_2": "SUITE 108",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352131211",
            "telephone_number": "205-592-4674",
            "fax_number": "205-592-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCLAIR ROAD IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "706-256-3450"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - FACILITY ID #",
            "identifier": "51056277",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RUTH SNOW, MD",
            "identifier": "1124000344",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N. MELINDA BERGQUIST, MD",
            "identifier": "1023040409",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JAMES SPANN, M.D. - BCBS OF ALABAMA",
            "identifier": "51116990",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC - PROVIDER ID #",
            "identifier": "1610921",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529906970",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CECIL EILAND, MD",
            "identifier": "1235111451",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JAMES  SPANN, M.D., NPI #",
            "identifier": "1306051164",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "470000833",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROBERT EICHELBERGER, MD",
            "identifier": "1427030642",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ImageSouth Montclair Road",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Makenna Brooke Monroy
• Jared Thayer Montague, ALC, NCC
• Janavi Devi Nathalie Montas Bello
• Montclair Psychiatric Services PC
• Montclair Rheumatology, PC
• Irvine Montebello-Alvarez
• Tamara Emmalyn Montes, MS, MED
• Laura Bridgette Montgomery-Barefield, MD
• Alyse Montgomery
• Caden Montgomery

• Radiology Clinic/Center in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Radiology Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.