Organization Active NPI

Therapeutic and Diagnostic Imaging LLC

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1164622965
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
THERAPEUTIC AND DIAGNOSTIC IMAGING LLC
Practice address
9930 Watson Rd
Saint Louis, MO 63126-1827
Phone
(314) 984-8827
Fax
(314) 627-1100
NPI assigned
Jul 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Authorized official

Name
Mr. John G. Landgraf
Title
Practice Manager
Phone
(314) 984-8827

Specialties & licenses 1

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

Addresses

Primary practice location

9930 Watson Rd
Saint Louis, MO 63126-1827

Mailing address

9930 Watson Rd
Saint Louis, MO 63126-1845
Phone (314) 984-8827

Other identifiers 1

IdentifierTypeStateIssuer
507429306MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070906000764 MO Part B Supplier - Clinic/Group Practice 1355434325 Receives reassigned benefits from 5 practitioners
Practice locations: Saint Louis, MO; St Louis, MO

National Provider Directory

National Provider Directory

Member organizations 2

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

Locations

17300 North Outer 40 Rd
Ste 101
Chesterfield, MO 63005
Phone (573) 442-1886

17000 Baxter Rd
Ste 103
Chesterfield, MO 63005

433 Lynn Haven Ln
Hazelwood, MO 63042
Phone (314) 551-0338

11652 Studt Ave
Saint Louis, MO 63141
Phone (314) 432-5002

12101 Olive Blvd
Saint Louis, MO 63141
Phone (314) 514-0167

9930 Watson Rd
Saint Louis, MO 63126
Phone (314) 984-8827

Practitioners & affiliated clinicians

Practitioners 5

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": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784505600000",
    "number": "1164622965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9930 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261845",
            "telephone_number": "314-984-8827",
            "fax_number": "314-985-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261827",
            "telephone_number": "314-984-8827",
            "fax_number": "314-627-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC AND DIAGNOSTIC IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A",
        "authorized_official_last_name": "LANDGRAF",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "314-984-8827",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507429306",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.