Active NPI
Gateway Imaging LLC
- Diagnostic Radiology Physician
- Newburgh, IN
National Provider Identifier
1144217241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- GATEWAY IMAGING LLC
- Practice address
- 4087 Gateway Blvd
Newburgh, IN 47630-8947 - Phone
- (812) 858-0080
- Fax
- (812) 858-6637
- NPI assigned
- Oct 4, 2005
- 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
- Kathleen B. Dockery
- Title
- Administrator
- Phone
- (812) 422-3254
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
4087 Gateway Blvd
Newburgh, IN 47630-8947
Mailing address
4087 Gateway Blvd
Newburgh, IN 47630-8947
Phone (812) 858-0080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DB0894 | Other | IN | RAILROAD MEDICARE |
Other names 1
- Midwest Radiologic Imaging
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D2070537 | Midwest Rad Imaging at Deaconess Gateway | Certificate of waiver | Dec 18, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Geriatric Medicine (Internal Medicine) Physician
- Evansville, IN
- NPI 1750399259
Member Of
Locations
4087 Gateway Blvd
Newburgh, IN 47630
Phone (812) 585-0080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1203552000000",
"number": "1144217241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4087 GATEWAY BLVD",
"city": "NEWBURGH",
"state": "IN",
"postal_code": "476308947",
"telephone_number": "812-858-0080",
"fax_number": "812-858-6637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4087 GATEWAY BLVD",
"city": "NEWBURGH",
"state": "IN",
"postal_code": "476308947",
"telephone_number": "812-858-0080",
"fax_number": "812-858-6637"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GATEWAY IMAGING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-04",
"last_updated": "2008-02-21",
"status": "A",
"authorized_official_last_name": "DOCKERY",
"authorized_official_first_name": "KATHLEEN",
"authorized_official_middle_name": "B.",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "812-422-3254"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DB0894",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Midwest Radiologic Imaging",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Newburgh, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.