NPIMap

Organization Active NPI

Diagnostic Radiology PC Vein Clinic

  • Vascular & Interventional Radiology Physician
  • Fairfax, MO
National Provider Identifier
1144650938
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
DIAGNOSTIC RADIOLOGY PC VEIN CLINIC
Practice address
26136 US Highway 59
Fairfax, MO 64446-9105
Phone
(308) 647-6444
Fax
(866) 902-2445
NPI assigned
Nov 15, 2013
Last updated
Nov 15, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
DIAGNOSTIC RADIOLOGY PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Authorized official

Name
Jo A Pohl, CPC
Title
Billing Manager
Phone
(308) 647-6444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X Primary

Addresses

Primary practice location

26136 US Highway 59
Fairfax, MO 64446-9105

Mailing address

PO Box 3521
Omaha, NE 68103-0521
Phone (308) 647-6444

National Provider Directory

National Provider Directory
Tax ID family
Diagnostic Radiology PC4 organizations share this tax ID, including this one
Part of
Diagnostic Radiology PC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1144650938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3521",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030521",
            "telephone_number": "308-647-6444",
            "fax_number": "866-902-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26136 US HIGHWAY 59",
            "city": "FAIRFAX",
            "state": "MO",
            "postal_code": "644469105",
            "telephone_number": "308-647-6444",
            "fax_number": "866-902-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC RADIOLOGY PC VEIN CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIAGNOSTIC RADIOLOGY PC",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "POHL",
        "authorized_official_first_name": "JO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "308-647-6444",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.