NPIMap

Organization Active NPI

Logan Park Imaging LLC

  • Diagnostic Radiology Physician
  • Herrin, IL
National Provider Identifier
1205831971
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
LOGAN PARK IMAGING LLC
Practice address
500 Lincoln Dr
Ste C
Herrin, IL 62948-6334
Phone
(618) 998-9633
Fax
(618) 998-9623
NPI assigned
Jun 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Wrophas Meeks, MDNPI 1881691756
Title
President/Provider
Phone
(618) 998-9633

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 IL Primary

Addresses

Primary practice location

500 Lincoln Dr
Ste C
Herrin, IL 62948-6334

Mailing address

500 Lincoln Dr
Ste C
Herrin, IL 62948-6334
Phone (618) 998-9633

National Provider Directory

National Provider Directory

Locations

500 Lincoln Dr
Ste C
Herrin, IL 62948
Phone (618) 998-9633

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1205831971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LINCOLN DR",
            "address_2": "STE C",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629486334",
            "telephone_number": "618-998-9633",
            "fax_number": "618-998-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LINCOLN DR",
            "address_2": "STE C",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629486334",
            "telephone_number": "618-998-9633",
            "fax_number": "618-998-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN PARK IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MEEKS",
        "authorized_official_first_name": "WROPHAS",
        "authorized_official_title_or_position": "PRESIDENT/PROVIDER",
        "authorized_official_telephone_number": "618-998-9633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.