NPIMap

Organization Active NPI

American Health Imaging of South Carolina, LLC

Doing business as American Health Imaging of Summerville

  • Radiology Clinic/Center
  • Summerville, SC
National Provider Identifier
1194395905
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
AMERICAN HEALTH IMAGING OF SOUTH CAROLINA, LLC
Doing business as
American Health Imaging of Summerville
Practice address
902 Nexton Square Dr
Summerville, SC 29486-7916
Phone
(843) 999-0558
NPI assigned
Jun 25, 2021
Last updated
Jul 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Authorized official

Name
Katrina Roelle
Title
Director of Credentialing
Phone
(614) 689-1691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

902 Nexton Square Dr
Summerville, SC 29486-7916

Mailing address

PO Box 745973
Atlanta, GA 30374-5973

Other names 1

  • American Health Imaging of Summerville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220311000273 SC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2062813413 Practice locations: Summerville, SC

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
42D2249578American Health Imaging of Summerville902 Nexton Square Drive, Summerville, SC 29486Certificate of waiverJan 20, 2028

National Provider Directory

National Provider Directory
Tax ID family
American Health Imaging of South Carolina LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

900 Nexton Square Dr
Ste 900
Summerville, SC 29486

902 Nexton Square Dr
Summerville, SC 29486
Phone (843) 999-0558

Practitioners & affiliated clinicians

Practitioners 57

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1194395905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 745973",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303745973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 NEXTON SQUARE DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867916",
            "telephone_number": "843-999-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN HEALTH IMAGING OF SOUTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-25",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "ROELLE",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "614-689-1691"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Health Imaging of Summerville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "American Health Imaging of Summerville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.