NPIMap

Organization Active NPI

Imaging Services of Jacksonville LLC

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1154586964
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
IMAGING SERVICES OF JACKSONVILLE LLC
Practice address
10475 Centurian Parkway
Jacksonville, FL 32256
Phone
(904) 928-1001
Fax
(904) 641-6298
NPI assigned
Jul 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Authorized official

Name
Lavelle R Hardin
Title
Managed Care Analyst
Phone
(615) 344-8203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

10475 Centurian Parkway
Jacksonville, FL 32256

Mailing address

10475 Centurian Parkway
Jacksonville, FL 32256
Phone (904) 928-1001

Other identifiers 1

IdentifierTypeStateIssuer
V3323OtherFLBCBS OF FL

National Provider Directory

National Provider Directory

Locations

10475 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 928-1001

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1154586964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10475 CENTURIAN PARKWAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-928-1001",
            "fax_number": "904-641-6298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10475 CENTURIAN PARKWAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-928-1001",
            "fax_number": "904-641-6298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGING SERVICES OF JACKSONVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "LAVELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGED CARE ANALYST",
        "authorized_official_telephone_number": "615-344-8203"
    },
    "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": "BCBS OF FL",
            "identifier": "V3323",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.