Jacksonville Diagnostic Imaging LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

JACKSONVILLE DIAGNOSTIC IMAGING LLC

Doing business as

NCDI-Mobile 3

Practice address

14215 Ballantyne Corporate PL
Charlotte, NC 28277-3670

Phone

(704) 384-1890

NPI assigned

Jul 29, 2009

Last updated

Aug 11, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Daniel J Schaefer

Title

C.O.O.

Phone

(770) 300-0101

Specialties & licenses 1

Addresses

Other names 1

• NCDI-Mobile 3 Doing business as

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1144451881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60598",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600598",
            "telephone_number": "678-992-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14215 BALLANTYNE CORPORATE PL",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773670",
            "telephone_number": "704-384-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE DIAGNOSTIC IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-29",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "770-300-0101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NCDI-Mobile 3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Renae Jackson, FNP
• Timothy William Jackson, D.P.T.
• Tonya Elaine Jackson, SLP
• Vashon Jackson, OT
• Victoria C Jackson
• Jacob S Bailey LLC
• Binu L. Jacob, MD
• Shibin Thomas Jacob, MD
• Joanna Bess Jacobitti, MA,CCC,SLP
• Caroline Jacobs, LCSWA

• Diagnostic Radiology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.