Organization Active NPI

MRI of Wilmington LLC

  • Diagnostic Radiology Physician
  • Wilmington, DE
National Provider Identifier
1265499784
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MRI OF WILMINGTON LLC
Practice address
1020 N Union St
Wilmington, DE 19805-2736
Phone
(302) 427-9855
Fax
(302) 427-9549
NPI assigned
Apr 27, 2006
Organization subpart
Yes
Parent organization
DIA PRACTICE ENTERPRISES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

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

Authorized official

Name
Victoria L Peacock, MS, MS
Title
Project Manager
Phone
(302) 993-2330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1020 N Union St
Wilmington, DE 19805-2736

Mailing address

1601 Milltown Rd
Suite 13
Wilmington, DE 19808-4027
Phone (302) 993-2330

Other identifiers 1

IdentifierTypeStateIssuer
0000611902MedicaidDE

National Provider Directory

National Provider Directory

Locations

1601 Milltown Rd
Ste 13
Wilmington, DE 19808
Phone (302) 683-4938

Practitioners & affiliated clinicians

Practitioners 7

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": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1265499784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MILLTOWN RD",
            "address_2": "SUITE 13",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198084027",
            "telephone_number": "302-993-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N UNION ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198052736",
            "telephone_number": "302-427-9855",
            "fax_number": "302-427-9549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRI OF WILMINGTON LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIA PRACTICE ENTERPRISES LLC",
        "enumeration_date": "2006-04-27",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROJECT MANAGER",
        "authorized_official_telephone_number": "302-993-2330",
        "authorized_official_credential": "MS, MS"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000611902",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.