Independent Radiology Associates PLC
Organization Active NPI Diagnostic Radiology Physician · Dyersburg, TN
NPI 1194804906 · NPPES record last updated Jan 11, 2010
Key facts
- NPI
- 1194804906
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- INDEPENDENT RADIOLOGY ASSOCIATES PLC
- Practice address
- 400 E Tickle St
Dyersburg, TN 38024 - Phone
- (731) 285-2346
- Fax
- (731) 285-4717
- NPI assigned
- Nov 3, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Jennifer P Caton
- Title
- Office Manager
- Phone
- (731) 285-2346
Practitioners 50
-
Mark Allen Jones, MD
-
Tanveer Aslam, MD
-
Rauf Baba, MD
-
Kelly Smith Barnes, APRN
-
Lauren Elizabeth Butler, APRN
-
Thomas Wade Carrington, R.P.A., R.R.A.
-
Syble S Carter, FNP
-
Karyn Dean, APN
-
Clarice Dobbs, APRN
-
Daniel R Fox, MD
-
James S Hausmann, MD
-
Tracey Kizer, NP
-
John E Lanier, PA
-
Kashif A Latif, M.D.
-
Clay Michael Marvin, FNP
-
Kelly M McCallum, APN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040929001253 | TN | Part B Supplier - Clinic/Group Practice | 6507835154 |
Receives reassigned benefits from 4 practitioners Practice locations: Union City, TN; Troy, TN; Tiptonville, TN; Ripley, TN; Martin, TN; Halls, TN; Alamo, TN; Brownsville, TN… |
National Provider Directory
Locations
27 Fox St
Poughkeepsie, NY 12601
Phone (914) 471-7417
305 W Court St
Dyersburg, TN 38024
Phone (731) 285-2346
656 Kimberly Dr
Henderson, TN 38340
Phone (731) 733-9044
321 E Harper St
Troy, TN 38260
Phone (731) 442-0956
1720 E Reelfoot Ave
Ste 104B
Union City, TN 38261
Phone (731) 225-2555
702 Sherrill St
Ste 3
Union City, TN 38261
Phone (731) 885-8884
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
400 E Tickle St
Dyersburg, TN 38024
Mailing address
PO Box 1296
Dyersburg, TN 38025-1296
Phone (731) 285-2346
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3705496 | Medicaid | TN |
Other providers in Dyersburg, TN
- Lynda J Hughes
- Human Technology, Inc.
- Janette Humpolick
- Shannon Janae Hurst
- Charlotte Elizabeth Hutcheson
- Courtney Cape Irvin
- Isd Renal Inc
- Jackson Madison County General
- Evelyn Nicole Jackson
- Christi L Jacobi
All providers in Dyersburg, TN · Diagnostic Radiology Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.