South Sound Radiology - Lewis County

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

SOUTH SOUND RADIOLOGY - LEWIS COUNTY

Practice address

914 S Scheuber Rd
Centralia, WA 98531-9027

Phone

(360) 330-8508

Fax

(360) 330-8583

NPI assigned

Dec 21, 2012

Last updated

Apr 18, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTH SOUND RADIOLOGIST INC P SAs reported in NPPES

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

Authorized official

Name

Mrs. Stephanie R Dirckx, M.D.

Title

Executive Director

Phone

(360) 493-4612

Specialties & licenses 1

Addresses

Other identifiers 2

Part of

South Sound Rad Inc PS

Practitioners 3

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.

• Tremont Vincent Parrino, MD

  • Diagnostic Radiology Physician
  • Olympia, WA
  • NPI 1932190154
  NPD
• Mehdi Rohany, M.D.

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1558578831
  NPD (past)
• Andrew Robert Taylor, M.D.

  • Diagnostic Radiology Physician
  • Olympia, WA
  • NPI 1699756783
  NPD (past)

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

{
    "created_epoch": "1356048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397779200000",
    "number": "1255677118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 ENSIGN RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065064",
            "telephone_number": "360-493-4600",
            "fax_number": "360-493-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 S SCHEUBER RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319027",
            "telephone_number": "360-330-8508",
            "fax_number": "360-330-8583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SOUND RADIOLOGY - LEWIS COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH SOUND RADIOLOGIST INC P S",
        "enumeration_date": "2012-12-21",
        "last_updated": "2014-04-18",
        "status": "A",
        "authorized_official_last_name": "DIRCKX",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-493-4612",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "311408",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "G8918611",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Levi Robert Soteros
• South Creek SNF Healthcare LLC (South Creek Post Acute)
• South Puget Sound ABA LLC (South Puget Sound ABA)
• South Sound Inpatient Physicians PLLC (Sound Inpatient Physicians)
• South Sound Oral Surgery PLLC
• Jordan Southern
• Southwest Washington Anesthesia PS
• Southwest Washington Diagnostics LP (Washington Diagnostics)
• Michael Spain
• Sarah C Spencer, ARNP

• Diagnostic Radiology Physician in Centralia, WA
• Providers in Centralia, WA by specialty
• Diagnostic Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; 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.