NPIMap

Organization Active NPI

Imagecare LLC

  • Diagnostic Radiology Physician
  • Columbia, SC
National Provider Identifier
1174596852
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
IMAGECARE LLC
Practice address
710 Rabon Rd Ste 100
Columbia, SC 29203-8903
Phone
(803) 256-7646
Fax
(803) 699-4073
NPI assigned
Feb 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Authorized official

Name
Mr. Geoffrey K. Gardner
Title
SVP Finance and Revenue Cycle
Phone
(336) 718-2078

Specialties & licenses 1

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

Addresses

Primary practice location

710 Rabon Rd Ste 100
Columbia, SC 29203-8903

Mailing address

3480 Preston Ridge Rd Ste 600
Alpharetta, GA 30005-5462
Phone (770) 300-0101

Other identifiers 1

IdentifierTypeStateIssuer
CA5940OtherSCRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040114000131 SC Part B Supplier - Clinic/Group Practice 8325949332 Receives reassigned benefits from 9 practitioners
Practice locations: Columbia, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D1078111Imagecare LLC710 Rabon Rd Ste 100, Columbia, SC 29203Certificate of waiverDec 30, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

710 Rabon Rd
Ste 100
Columbia, SC 29203
Phone (803) 256-7646

3000 NE Medical Park
Columbia, SC 29223

Practitioners & affiliated clinicians

Practitioners 9

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": "1139616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1174596852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 PRESTON RIDGE RD STE 600",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300055462",
            "telephone_number": "770-300-0101",
            "fax_number": "678-992-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 RABON RD STE 100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038903",
            "telephone_number": "803-256-7646",
            "fax_number": "803-699-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-11",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "SVP FINANCE AND REVENUE CYCLE",
        "authorized_official_telephone_number": "336-718-2078",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA5940",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.