NPIMap

Organization Active NPI

Somerset Outpatient Diagnostic Center

  • Mammography Radiologic Technologist
  • Somerset, KY
National Provider Identifier
1205858099
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mammography Radiologic TechnologistTaxonomy code 2471M2300X
License
FDA #169292 Issued in KY
Legal business name
SOMERSET OUTPATIENT DIAGNOSTIC CENTER
Practice address
600 Bogle St
Suite 3
Somerset, KY 42503-2885
Phone
(606) 678-4114
Fax
(606) 679-5862
NPI assigned
Jul 24, 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
Mrs. Lisa Ann Mitchell
Title
Office Manager
Phone
(606) 678-4114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mammography Radiologic TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 2471M2300X FDA #169292 KY Primary

Addresses

Primary practice location

600 Bogle St
Suite 3
Somerset, KY 42503-2885

Mailing address

600 Bogle St
Suite 3
Somerset, KY 42503-2885
Phone (606) 678-4114

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205858099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BOGLE ST",
            "address_2": "SUITE 3",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032885",
            "telephone_number": "606-678-4114",
            "fax_number": "606-679-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BOGLE ST",
            "address_2": "SUITE 3",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032885",
            "telephone_number": "606-678-4114",
            "fax_number": "606-679-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERSET OUTPATIENT DIAGNOSTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-678-4114",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2471M2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Mammography",
            "state": "KY",
            "license": "FDA #169292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

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.