South County Pet Imaging, LLC

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

Legal business name

SOUTH COUNTY PET IMAGING, LLC

Practice address

10010 Kennerly Rd
Saint Louis, MO 63128-2106

Phone

(314) 525-1748

Fax

(314) 525-1849

NPI assigned

Dec 13, 2005

Last updated

Jul 21, 2022By 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

Jeffrey B Judd, M.D.NPI 1689659039

Title

Director of Radiology

Phone

(314) 525-1748

Specialties & licenses 1

Addresses

Other identifiers 3

Member of 1

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

• Mercy Hospital South

  dba Mercy Home Health

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1053314179

  Member Of

  NPD member

Practitioners 1

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.

• Jeffrey B Judd, M.D.

  • Diagnostic Radiology Physician
  • Saint Louis, MO
  • NPI 1689659039
  Authorized official Same address or phone

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1285619189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843840",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843840",
            "telephone_number": "314-821-8055",
            "fax_number": "314-821-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1748",
            "fax_number": "314-525-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COUNTY PET IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JUDD",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR OF RADIOLOGY",
        "authorized_official_telephone_number": "314-525-1748",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "122078",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1601756",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "154920",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South County Orthopedics and Sports Medicine Inc
• South County Outpatient Surgery Center LP
• South County Pain Institute LLC
• South County Pain Institute LLC
• South County Pediatric Associates PC
• South County Radiologists, Inc
• South County Sport & Spine, LLC
• South County Surgical Center, LLC
• South County Surgical Services, LLC
• South County Urological, Inc.

• Body Imaging Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Body Imaging Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.