NPIMap

Organization Active NPI

Marion Diagnostic Center LLC

  • Diagnostic Radiology Physician
  • Marion, IL
National Provider Identifier
1275006744
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MARION DIAGNOSTIC CENTER LLC
Practice address
3003 Civic Circle Blvd Ste 200
Marion, IL 62959-5259
Phone
(618) 993-1400
Fax
(618) 993-1522
NPI assigned
Jan 8, 2019
Last updated
Sep 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Authorized official

Name
Shari D. Gamble, BSN, RN
Title
Nurae Administrator
Phone
(618) 993-1400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

3003 Civic Circle Blvd Ste 200
Marion, IL 62959-5259

Mailing address

3003 Civic Circle Blvd Ste 200
Marion, IL 62959-5259
Phone (618) 993-1400

National Provider Directory

National Provider Directory
Tax ID family
Marion Diagnostic Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1275006744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 CIVIC CIRCLE BLVD STE 200",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595259",
            "telephone_number": "618-993-1400",
            "fax_number": "618-993-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 CIVIC CIRCLE BLVD STE 200",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595259",
            "telephone_number": "618-993-1400",
            "fax_number": "618-993-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION DIAGNOSTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "SHARI",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "NURAE ADMINISTRATOR",
        "authorized_official_telephone_number": "618-993-1400",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.