Iredell Radiology Associates PA

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

IREDELL RADIOLOGY ASSOCIATES PA

Practice address

548 Brookdale Dr
Statesville, NC 28677-4108

Phone

(704) 872-6122

NPI assigned

May 2, 2006

Last updated

Jul 8, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gerry Wilson

Title

Office Manager

Phone

(704) 872-6122

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

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.

• Reid Breckwoldt

  • Diagnostic Radiology Physician
  • Huntersville, NC
  • NPI 1295737583
  NPD (past)
• Deborah Ann Dipersio, MD

  • Diagnostic Radiology Physician
  • Wilmington, NC
  • NPI 1972504272
  NPD (past)
• James C. Lorentzen, MD

  • Diagnostic Radiology Physician
  • New Bern, NC
  • NPI 1205818226
  NPD (past)
• Aous S Al-Khaldi, MD

  • Diagnostic Radiology Physician
  • Warner Robins, GA
  • NPI 1548222094
  NPD (past)

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278547200000",
    "number": "1235197179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774108",
            "telephone_number": "704-872-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IREDELL RADIOLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2010-07-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "GERRY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-872-6122"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890184B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iredell Physician Network, LLC (Iredell Urology)
• Iredell Physician Network, LLC (Ruby Grimm, M.D.)
• Iredell Physician Network, LLC (Iredell Cardiology)
• Iredell Physician Network, LLC (Iredell Pain Management)
• Iredell Physician Network, LLC (Iredell Pediatrics)
• Iredell Surgical Associates, LLP (Iredell Surgical Center)
• Iredell-Statesville Schools
• Iredell-Statesville Schools
• Daniela Getuza Isfan, M.D.
• Jarrett Isler

• Diagnostic Radiology Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; 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.