NPIMap

Organization Active NPI

Nova Radiology Consultants, LLC

  • Diagnostic Radiology Physician
  • Poplar Bluff, MO
National Provider Identifier
1285883496
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NOVA RADIOLOGY CONSULTANTS, LLC
Practice address
2620 N Westwood Blvd
Poplar Bluff, MO 63901-3396
Phone
(918) 664-9892
NPI assigned
Sep 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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

Authorized official

Name
Dr. Alejandro Mendez, MD
Title
Owner
Phone
(314) 780-3388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

2620 N Westwood Blvd
Poplar Bluff, MO 63901-3396

Mailing address

4500 S Garnett Rd
Suite 300
Tulsa, OK 74146-5229
Phone (918) 664-9892

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221091200000",
    "number": "1285883496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD",
            "address_2": "SUITE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465229",
            "telephone_number": "918-664-9892",
            "fax_number": "918-392-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013396",
            "telephone_number": "918-664-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA RADIOLOGY CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2008-09-11",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-780-3388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

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