Independent Imaging, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

LC0773278 Issued in MO

Legal business name

INDEPENDENT IMAGING, LLC

Practice address

500 Porter Ave
Aurora, MO 65605-2365

Phone

(417) 678-7880

NPI assigned

Jan 15, 2007

Last updated

Apr 11, 2008By 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

Mr. Jeffrey L Shore, MD

Title

President

Phone

(314) 821-5600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207872000000",
    "number": "1265583462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 DEER TRACKS TRL",
            "address_2": "SUITE 130",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311839",
            "telephone_number": "314-821-5600",
            "fax_number": "314-821-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PORTER AVE",
            "city": "AURORA",
            "state": "MO",
            "postal_code": "656052365",
            "telephone_number": "417-678-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2008-04-11",
        "status": "A",
        "authorized_official_last_name": "SHORE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-821-5600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "LC0773278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Elizabeth Hodges
• Paula Hokanson, MHPP, PLPC
• Charla Faye Holst
• Kimberly S Huggins, M.D.
• Christie J. Hurt, DO
• Deborah Leann Inman, LMT, KTP
• Susan Inman, NP
• Richard Jenkins, LPC
• John a. Watts, DC, LLC
• Vanessa M Johnston, L.C.S.W.

• Diagnostic Radiology Physician in Aurora, MO
• Providers in Aurora, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.