NPIMap

Organization Active NPI

Central Louisiana Imaging Center LLC

  • Radiology Clinic/Center
  • Alexandria, LA
National Provider Identifier
1295733616
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
CENTRAL LOUISIANA IMAGING CENTER LLC
Practice address
3704 North Blvd
Suite 1
Alexandria, LA 71301
Phone
(318) 442-8399
Fax
(318) 448-9897
NPI assigned
Jul 9, 2005
Last updated
May 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Authorized official

Name
Alfed Ameen Mansour Jr., MD
Title
Director
Phone
(318) 442-8399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

3704 North Blvd
Suite 1
Alexandria, LA 71301

Mailing address

3704 North Blvd
Suite 1
Alexandria, LA 71301
Phone (318) 442-8399

Other identifiers 1

IdentifierTypeStateIssuer
1447226MedicaidLA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1120867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1295733616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 NORTH BLVD",
            "address_2": "SUITE 1",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71301",
            "telephone_number": "318-442-8399",
            "fax_number": "318-448-9897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 NORTH BLVD",
            "address_2": "SUITE 1",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71301",
            "telephone_number": "318-442-8399",
            "fax_number": "318-448-9897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL LOUISIANA IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-09",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "ALFED",
        "authorized_official_middle_name": "AMEEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "318-442-8399",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447226",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.