Oregon Advanced Imaging, LLC

Primary specialty

Magnetic Resonance Imaging Radiologic TechnologistTaxonomy code 2471M1202X

Legal business name

OREGON ADVANCED IMAGING, LLC

Practice address

545 Medical Center Dr
Medford, OR 97504

Phone

(541) 773-8661

Fax

(541) 842-9206

NPI assigned

Jun 5, 2008

Last updated

Jun 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lynette K Gundlach

Title

Bookkeeper

Phone

(541) 608-8791

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1184883118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1527",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010114",
            "telephone_number": "541-773-8661",
            "fax_number": "541-842-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 MEDICAL CENTER DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-773-8661",
            "fax_number": "541-842-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON ADVANCED IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "GUNDLACH",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "541-608-8791",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2471M1202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100183",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.