Lad Imaging LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

LAD IMAGING LLC

Practice address

1193 South Woodland Blvd
Deland, FL 32720-7416

Phone

(386) 574-5748

Fax

(386) 574-0712

NPI assigned

Oct 31, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Lavelle R Hardin

Title

Credentialing Coordinator

Phone

(615) 344-8203

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1194716118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1193 SOUTH WOODLAND BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327207416",
            "telephone_number": "386-574-5748",
            "fax_number": "386-574-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193 SOUTH WOODLAND BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327207416",
            "telephone_number": "386-574-5748",
            "fax_number": "386-574-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAD IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "LAVELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "615-344-8203",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "V2977",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280838200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chaima Kuck, APRN
• Christi Kush, PSY.D.
• Cynthia Kwalwasser, OTR
• Laboratory Corporation of America
• Brooke A Lacey, APRN
• Jeanette L Lain, P.A.
• Albert Dustin Laird
• Jonathan Philip Phi Hai Lam, MD
• Nicholas James Lambert, PT, DPT
• Christine Lamee, PTA

• Radiology Clinic/Center in Deland, FL
• Providers in Deland, FL by specialty
• Radiology Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.