Organization Active NPI

JCC, LLC

Doing business as Pdi Dayton

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Dayton, OH
National Provider Identifier
1144466293
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
JCC, LLC
Doing business as
Pdi Dayton
Practice address
5692 Far Hills Ave
Suite 1H
Dayton, OH 45429-2202
Phone
(937) 438-3384
Fax
(937) 438-3394
NPI assigned
Dec 19, 2008
Last updated
Apr 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Authorized official

Name
Jack Champney CornellNPI 1760298251
Title
President/Ceo
Phone
(440) 223-8848

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X NU Primary
Diagnostic Radiology Physician 2085R0202X NU

Addresses

Primary practice location

5692 Far Hills Ave
Suite 1H
Dayton, OH 45429-2202

Mailing address

15371 Hemlock Point Road
Chagrin Falls, OH 44022-3801
Phone (855) 734-2645

Other practice location 1

2591 Miamisburg Centerville Rd Ste 102
Centerville, OH 45459-3706
Phone (937) 438-3384

Other identifiers 1

IdentifierTypeStateIssuer
3009112MedicaidOH

Other names 1

  • PDI DAYTON Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091015000069 OH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8123197894 Practice locations: Centerville, OH
O20200221001802 GA Part B Supplier - Clinic/Group Practice 8123197894 Receives reassigned benefits from 1 practitioner
Practice locations: Smyrna, GA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

Dept AT 952550
Atlanta, GA 31192

5192 Chillicothe Rd
Ste 102
Chagrin Falls, OH 44022
Phone (440) 338-8959

5692 Far Hills Ave
Ste 1H
Dayton, OH 45429
Phone (937) 438-3384

800 Pike St
Ste 1
Marietta, OH 45750
Phone (740) 374-7500

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1229644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1144466293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15371 HEMLOCK POINT ROAD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440223801",
            "telephone_number": "855-734-2645",
            "fax_number": "855-734-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5692 FAR HILLS AVE",
            "address_2": "SUITE 1H",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292202",
            "telephone_number": "937-438-3384",
            "fax_number": "937-438-3394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2591 Miamisburg Centerville Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454593706",
            "country_code": "US",
            "telephone_number": "937-438-3384",
            "fax_number": "937-438-3394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JCC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-19",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "CORNELL",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "CHAMPNEY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "440-223-8848"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3009112",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PDI DAYTON",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PDI DAYTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.