Diaspora Radiology, SC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

DIASPORA RADIOLOGY, SC

Practice address

3004 Golf Rd Ste 101
Eau Claire, WI 54701-8794

Phone

(855) 694-3300

NPI assigned

May 13, 2022

Organization subpart

Yes

Parent organization

DIASPORA RADIOLOGY, SCAs reported in NPPES

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

Authorized official

Name

Maria Corona

Title

Administrative Director

Phone

(855) 694-3300

Specialties & licenses 2

Addresses

Other names 1

• Diaspora Radiology dba Smart Scan Medical Imaging Doing business as

Tax ID family

Diaspora Radiology SC4 organizations share this tax ID, including this one

Part of

Diaspora Radiology SC

Other organizations with this tax ID 3

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

• Diaspora Radiology, SC

  • Radiology Clinic/Center
  • Middleton, WI
  • NPI 1043937899
  NPD tax ID
• Diaspora Radiology, SC

  • Diagnostic Radiology Physician
  • Weston, WI
  • NPI 1861119612
  NPD tax ID
• Diaspora Radiology, SC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Northbrook, IL
  • NPI 1730652017
  NPD tax ID

Locations

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1306583174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772555",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482772620",
            "telephone_number": "314-238-5260",
            "fax_number": "314-821-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 GOLF RD STE 101",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547018794",
            "telephone_number": "855-694-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIASPORA RADIOLOGY, SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIASPORA RADIOLOGY, SC",
        "enumeration_date": "2022-05-13",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "CORONA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "855-694-3300"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diaspora Radiology dba Smart Scan Medical Imaging",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diaspora Radiology dba Smart Scan Medical Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher James Devlin, CFA
• Nicholas Dewerd, DPT
• Travis Scott Dewitt, CPSS
• Donn David Dexter, MD
• Nicole Deziel, LPC
• Anthony Diebes, MD
• Darla Diermeier, CEP
• Michael D Diestelmeier, MD
• Robin Gertrud Dietrich, APSW
• Heather Renee Dillard

• Magnetic Resonance Imaging (MRI) Clinic/Center in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.