FS Outpatient Imaging Center LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

FS OUTPATIENT IMAGING CENTER LLC

Practice address

6308 8TH Ave
Kenosha, WI 53143-5031

Phone

(262) 656-2950

NPI assigned

Jun 28, 2024

Organization subpart

No

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

Authorized official

Name

Thomas J Kelley

Title

Sole Member

Phone

(262) 577-8765

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1306681515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-656-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FS OUTPATIENT IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "262-577-8765"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Radiology Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.