NPIMap

Organization Active NPI

Btdi JV LLP

  • Physiological Laboratory
  • Southlake, TX
National Provider Identifier
1265870604
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
BTDI JV LLP
Practice address
925 E Southlake Blvd Ste 120&220
Southlake, TX 76092-1476
Phone
(817) 424-4800
NPI assigned
Jun 7, 2013
Organization subpart
Yes
Parent organization
BTDI JV LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Katrina Roelle
Title
Director of Credentialing
Phone
(614) 689-1691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

925 E Southlake Blvd Ste 120&220
Southlake, TX 76092-1476

Mailing address

PO Box 746003
Atlanta, GA 30374-6003

Other names 1

  • Touchstone Imaging Southlake Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131220001633 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9931336336 Practice locations: Southlake, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0916018Baylor Scott & White Southlake Family Medicine925 E Southlake Blvd Suite 100, Southlake, TX 76092Certificate of waiverAug 27, 2027
45D1031670Btdi JV, LLP Touchstone Imaging Southlake925 E Southlake Blvd, Suite 120 & 220, Southlake, TX 76092Certificate of waiverMar 23, 2028
45D2251077BSW Southlake Urgent Care925 E Southlake Blvd Suite 270, Southlake, TX 76092Certificate of waiverJan 31, 2028
45D2328211BSW Southlake Pediatrics925 E Southlake Blvd Suite 260, Southlake, TX 76092Certificate of waiverAug 5, 2027

National Provider Directory

National Provider Directory
Tax ID family
Btdi JV LLP41 organizations share this tax ID, including this one
Part of
Btdi JV LLP

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

925 E Southlake Blvd
Ste 120220
Southlake, TX 76092
Phone (817) 424-4800

Practitioners & affiliated clinicians

Practitioners 102

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 102

NPI Registry JSON

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1265870604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746003",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 E SOUTHLAKE BLVD STE 120&220",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921476",
            "telephone_number": "817-424-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BTDI JV LLP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BTDI JV LLP",
        "enumeration_date": "2013-06-07",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "ROELLE",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "614-689-1691"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Touchstone Imaging Southlake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.