NPIMap

Organization Active NPI

William M. Kelly M.D., Inc.

Doing business as Health Scan Imaging, Truly Open MRI, and Open MRI of Loma Linda

  • Specialist
  • Palm Desert, CA
National Provider Identifier
1306078225
Registry record updated Oct 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A34125 Issued in CA
Legal business name
WILLIAM M. KELLY M.D., INC.
Doing business as
Health Scan Imaging, Truly Open MRI, and Open MRI of Loma Linda
Practice address
72980 Fred Waring Dr
Suite a
Palm Desert, CA 92260-2898
Phone
(760) 776-8001
Fax
(760) 836-3934
NPI assigned
Aug 11, 2009
Last updated
Oct 18, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
WILLIAM M. KELLY M.D., INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 18, 2013

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

Authorized official

Name
Tania Chang
Title
Credentialing/Contrac Administrator
Phone
(760) 776-8001

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X A34125 CA Primary
Diagnostic Neuroimaging (Radiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085D0003X

Addresses

Primary practice location

72980 Fred Waring Dr
Suite a
Palm Desert, CA 92260-2898

Mailing address

44489 Town Center Way
Suite D Box 540
Palm Desert, CA 92260-2789
Phone (760) 776-8001

Other identifiers 1

IdentifierTypeStateIssuer
00A341250MedicaidCA

Other names 1

  • Health Scan Imaging, Truly Open MRI, and Open MRI of Loma Linda Doing business as

National Provider Directory

National Provider Directory
Tax ID family
William M Kelly MD Inc10 organizations share this tax ID, including this one
Part of
William M Kelly MD Inc

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382054400000",
    "number": "1306078225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44489 TOWN CENTER WAY",
            "address_2": "SUITE D BOX 540",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602789",
            "telephone_number": "760-776-8001",
            "fax_number": "760-836-3934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72980 FRED WARING DR",
            "address_2": "SUITE A",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602898",
            "telephone_number": "760-776-8001",
            "fax_number": "760-836-3934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM M. KELLY M.D., INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAM M. KELLY M.D., INC.",
        "enumeration_date": "2009-08-11",
        "last_updated": "2013-10-18",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "TANIA",
        "authorized_official_title_or_position": "CREDENTIALING/CONTRAC ADMINISTRATOR",
        "authorized_official_telephone_number": "760-776-8001"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A34125",
            "primary": true
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A341250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Scan Imaging, Truly Open MRI, and Open MRI of Loma Linda",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; 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.