Shared Imaging

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

SHARED IMAGING

Practice address

2801 Medical Center Dr
Pocahontas, AR 72455-9436

Phone

(630) 483-3980

Fax

(630) 483-3986

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Raymond Stachowiak

Title

President

Phone

(630) 483-3980

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1275676983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 PHOENIX LAKE AVE",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072363",
            "telephone_number": "630-483-3980",
            "fax_number": "630-483-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 MEDICAL CENTER DR",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724559436",
            "telephone_number": "630-483-3980",
            "fax_number": "630-483-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARED IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "STACHOWIAK",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-483-3980",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "5F825",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa D Rouse, LCSW
• Myra Kathleen Rowe, DO
• Jaci Salario, QBHP
• Jennifer D. Salyards, LCSW
• Steven Adam Salyards, CCC-SLP
• Amanda Shaw
• Sheridan Occupational Therapy Services, Inc.
• Holly Jill Sheridan
• Michael Sheridan
• Ashlyn Katherine Shipley, CCC-SLP

• Radiology Clinic/Center in Pocahontas, AR
• Providers in Pocahontas, AR by specialty
• Radiology Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.