Organization Active NPI

Diagnostic Imaging Associates

  • Diagnostic Radiology Physician
  • Shreveport, LA
National Provider Identifier
1194807271
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DIAGNOSTIC IMAGING ASSOCIATES
Practice address
1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone
(318) 798-4300
NPI assigned
Oct 19, 2006
Last updated
Mar 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Authorized official

Name
John Hebert, MDNPI 1538100805
Title
President
Phone
(318) 572-4403

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800

Mailing address

PO Box 3488
Dept 05-042
Tupelo, MS 38803-3488
Phone (855) 896-8453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, FL, CA, WI, NY, MI, CO, MS, IL, NC, KY, WV12 enrollments

Enrollment records 12

Enrollment IDStateProvider typePAC IDDetails
O20041118000039 LA Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 12 practitioners
Practice locations: Shreveport, LA; Bossier City, LA
O20230814003503 FL Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 3 practitioners
Practice locations: Crystal River, FL; Lakewood Ranch, FL; Miami Beach, FL
O20230815002636 CA Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 3 practitioners
Practice locations: Garden Grove, CA; Los Angeles, CA; Newport Beach, CA
O20230816001195 WI Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 1 practitioner
Practice locations: Mequon, WI
O20230914000912 NY Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 5 practitioners
Practice locations: Dix Hills, NY; New York, NY; Rochester, NY
O20231005003184 MI Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 2 practitioners
Practice locations: Beverly Hills, MI; Northville, MI
O20231012000302 CO Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 2 practitioners
Practice locations: Denver, CO; Monument, CO
O20231023001343 MS Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 2 practitioners
Practice locations: Meridian, MS; Olive Branch, MS
O20231205003243 IL Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 1 practitioner
Practice locations: Oak Brook, IL
O20240326003170 NC Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 1 practitioner
Practice locations: Durham, NC
O20240415001966 KY Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 1 practitioner
Practice locations: Elizabethtown, KY
O20241126002709 WV Part B Supplier - Clinic/Group Practice 9133183213 Receives reassigned benefits from 1 practitioner
Practice locations: Huntington, WV

National Provider Directory

National Provider Directory

Locations

12093 Brookhurst St
Garden Grove, CA 92840

1800 Buckner St
Ste B100
Shreveport, LA 71101
Phone (318) 681-4347

Practitioners & affiliated clinicians

Practitioners 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1194807271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3488",
            "address_2": "DEPT 05-042",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033488",
            "telephone_number": "855-896-8453",
            "fax_number": "855-286-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711056800",
            "telephone_number": "318-798-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC IMAGING ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-572-4403",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.