NPIMap

Organization Active NPI

Shared Medical Services, Inc.

  • Mobile Radiology Clinic/Center
  • Cottage Grove, WI
National Provider Identifier
1295785079
Registry record updated Jul 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
License
25120901 Issued in WI
Legal business name
SHARED MEDICAL SERVICES, INC.
Practice address
209 Limestone Pass
Cottage Grove, WI 53527
Phone
(608) 839-9050
Fax
(608) 839-8950
NPI assigned
May 11, 2006
Last updated
Jul 19, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2017

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

Authorized official

Name
Lisa A Arington
Title
Ceo/President
Phone
(608) 839-9050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X 25120901 WI Primary

Addresses

Primary practice location

209 Limestone Pass
Cottage Grove, WI 53527

Mailing address

209 Limestone Pass
Cottage Grove, WI 53527-8968
Phone (608) 839-9050

Other names 1

  • Northern Shared Medical Services, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131220001464 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1254245871 Practice locations: Greenville, TX
O20180803001554 WI Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1254245871 Practice locations: Janesville, WI; Cottage Grove, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D1014984Shared Medical Services209 Limestone Pass, Cottage Grove, WI 53527Certificate of waiverJul 21, 2027

National Provider Directory

National Provider Directory

Locations

2504 W Main St
Russellville, AR 72801
Phone (479) 967-2024

1133 31st Ave
Council Bluffs, IA 51501
Phone (712) 366-3900

5445 Avenue O
Fort Madison, IA 52627
Phone (319) 372-6530

1432 Southwest Blvd
Jefferson Cty, MO 65109
Phone (573) 632-5560

5301 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-1066

209 Limestone Pass
Cottage Grove, WI 53527
Phone (608) 839-9050

4235 Argosy Ct
Madison, WI 53714
Phone (608) 663-6080

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500422400000",
    "number": "1295785079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 LIMESTONE PASS",
            "city": "COTTAGE GROVE",
            "state": "WI",
            "postal_code": "535278968",
            "telephone_number": "608-839-9050",
            "fax_number": "608-839-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 LIMESTONE PASS",
            "city": "COTTAGE GROVE",
            "state": "WI",
            "postal_code": "53527",
            "telephone_number": "608-839-9050",
            "fax_number": "608-839-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARED MEDICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2017-07-19",
        "status": "A",
        "authorized_official_last_name": "ARINGTON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "608-839-9050"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "WI",
            "license": "25120901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Shared Medical Services, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Cottage Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.