NPIMap

Organization Active NPI

Carrollwood Diagnostic Imaging

Doing business as Premier Imaging

  • Diagnostic Radiology Physician
  • Tampa, FL
National Provider Identifier
1194778241
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
114748 0000 Issued in FL
Legal business name
CARROLLWOOD DIAGNOSTIC IMAGING
Doing business as
Premier Imaging
Practice address
7171 N Dale Mabry Hwy
Tampa, FL 33614-2630
Phone
(813) 932-2222
Fax
(813) 985-8006
NPI assigned
May 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ellis B. Norsoph, M.D.NPI 1811940885
Title
President
Phone
(813) 899-6220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 114748 0000 FL Primary

Addresses

Primary practice location

7171 N Dale Mabry Hwy
Tampa, FL 33614-2630

Mailing address

PO Box 47269
Tampa, FL 33647-0111
Phone (813) 899-6220

Other identifiers 1

IdentifierTypeStateIssuer
V2765OtherFLBCBS OF FLORIDA

Other names 1

  • Premier Imaging Doing business as

National Provider Directory

National Provider Directory

Locations

7171 N Dale Mabry Hwy
Ste 101
Tampa, FL 33614
Phone (813) 615-7398

Practitioners & affiliated clinicians

Practitioners 36

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 36

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194778241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47269",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336470111",
            "telephone_number": "813-899-6220",
            "fax_number": "813-985-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142630",
            "telephone_number": "813-932-2222",
            "fax_number": "813-985-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLLWOOD DIAGNOSTIC IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NORSOPH",
        "authorized_official_first_name": "ELLIS",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-899-6220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "114748 0000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "V2765",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.