NPIMap

Organization Active NPI

Radiology Services of Ardmore, Inc.

  • Diagnostic Radiology Physician
  • Ardmore, OK
National Provider Identifier
1124123963
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY SERVICES OF ARDMORE, INC.
Practice address
1011 14TH Ave NW
Ardmore, OK 73401-1828
Phone
(479) 452-9416
Fax
(479) 484-0827
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Authorized official

Name
Mrs. Julie Dibrell-Garcia
Title
Manager
Phone
(479) 452-9419

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085N0904X OK
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X OK Primary
Diagnostic Ultrasound PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085U0001X OK

Addresses

Primary practice location

1011 14TH Ave NW
Ardmore, OK 73401-1828

Mailing address

PO Box 518
Ardmore, OK 73402-0518
Phone (479) 452-9416

Other identifiers 1

IdentifierTypeStateIssuer
100730410AMedicaidOK

Other names 1

  • RSA Other name

National Provider Directory

National Provider Directory

Locations

1023 15th Ave NW
Ardmore, OK 73401
Phone (580) 223-7844

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594944000000",
    "number": "1124123963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734020518",
            "telephone_number": "479-452-9416",
            "fax_number": "479-484-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 14TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011828",
            "telephone_number": "479-452-9416",
            "fax_number": "479-484-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY SERVICES OF ARDMORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A",
        "authorized_official_last_name": "DIBRELL-GARCIA",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-452-9419",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": null,
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "OK",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100730410A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RSA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "RSA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ardmore, OK

Sources for this page

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