NPIMap

Organization Active NPI

XRC Clinical Radiology, LLC

  • Vascular & Interventional Radiology Physician
  • South Bend, IN
National Provider Identifier
1154856789
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
XRC CLINICAL RADIOLOGY, LLC
Practice address
121 S Saint Louis Blvd
South Bend, IN 46617-2924
Phone
(574) 233-3123
Fax
(574) 233-3125
NPI assigned
Apr 20, 2017
Organization subpart
Yes
Parent organization
X-RAY CONSULTANTS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Authorized official

Name
Dale T. Huffman, PH.D.
Title
Chief Financial Executive
Phone
(571) 233-3123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X Primary

Addresses

Primary practice location

121 S Saint Louis Blvd
South Bend, IN 46617-2924

Mailing address

PO Box 4016
South Bend, IN 46634-4016

National Provider Directory

National Provider Directory
Part of
Xray Consultants Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1154856789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4016",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466344016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S SAINT LOUIS BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172924",
            "telephone_number": "574-233-3123",
            "fax_number": "574-233-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XRC CLINICAL RADIOLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "X-RAY CONSULTANTS, INC.",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "HUFFMAN",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL EXECUTIVE",
        "authorized_official_telephone_number": "571-233-3123",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.