Individual provider Active NPI

Louis Michael Radnothy, D.O.

  • Emergency Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1184709594
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4480 Issued in AZ
Practice address
5210 N 19TH Ave
Suite 121
Phoenix, AZ 85015-2946
Phone
(928) 920-0782
Fax
(928) 328-3635
NPI assigned
Oct 25, 2006
Last updated
Sep 25, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4480 AZ Primary

Addresses

Primary practice location

5210 N 19TH Ave
Suite 121
Phoenix, AZ 85015-2946

Mailing address

PO Box 3147
Yuma Proving Grounds
Yuma, AZ 85365-0903
Phone (928) 920-0782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121005000371 NC Practitioner - Emergency Medicine 5395841951 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.49 of 100Reported as group
Quality
89.76
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4480AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina Emergency Physicians, PLLC Emergency Medicine CurrentSince Nov 22, 2023 Accepting new patients
Vidant Medical Group LLC CurrentSince Sep 2, 2018 Accepting new patients
Columbus Emergency Group LLC Emergency Medicine CurrentSince Sep 1, 2012 Accepting new patients
Center for Physical Medicine & Rehabilitation P C Past Accepting new patients
Med 97 LLC Past Accepting new patients
Louis J Radnothy DO PA Past Accepting new patients
Weirsdale Family Health Center Inc PastSince May 1, 2013 Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

500 Jefferson St
Whiteville, NC 28472
Phone (910) 642-1776

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/ECJJAD
  • Direct secure messaging: lradnothy2710651@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1184709594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3147",
            "address_2": "YUMA PROVING GROUNDS",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853650903",
            "telephone_number": "928-920-0782",
            "fax_number": "928-328-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5210 N 19TH AVE",
            "address_2": "SUITE 121",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152946",
            "telephone_number": "928-920-0782",
            "fax_number": "928-328-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADNOTHY",
        "first_name": "LOUIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "4480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.