Central Memphis Regional Pet Imaging Center, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

NA Issued in TN

Legal business name

CENTRAL MEMPHIS REGIONAL PET IMAGING CENTER, LLC

Practice address

1388 Madison Ave
Memphis, TN 38104-2327

Phone

(901) 276-6413

Fax

(901) 276-3838

NPI assigned

Dec 5, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Mark Gabriel

Title

Principal

Phone

(317) 634-2222

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295719110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2121",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381590001",
            "telephone_number": "901-276-6413",
            "fax_number": "901-276-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1388 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042327",
            "telephone_number": "901-276-6413",
            "fax_number": "901-276-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MEMPHIS REGIONAL PET IMAGING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "317-634-2222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "TN",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in Memphis, TN
• Providers in Memphis, TN by specialty
• Radiology Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.