Western MD Pet Imaging LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

WESTERN MD PET IMAGING LLC

Practice address

952 Seton Dr
Cumberland, MD 21502-1950

Phone

(301) 777-3522

Fax

(301) 777-1902

NPI assigned

May 23, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Jong K Kim, M.D.

Title

President

Phone

(301) 724-1646

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1306849351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 808",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215010808",
            "telephone_number": "301-724-1646",
            "fax_number": "301-724-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "952 SETON DR",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215021950",
            "telephone_number": "301-777-3522",
            "fax_number": "301-777-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MD PET IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JONG",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-724-1646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0208472000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB6053",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD BLUE SHIELD",
            "identifier": "J248",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD BLUE SHIELD",
            "identifier": "217A",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Western Maryland Health System Corporation
• Western Maryland Pain & Rehabilitation Center LLC.
• Western Maryland Peritoneal Dialysis, LLC
• Western Maryland Stone Center
• Western Maryland Surgicenter LLP
• John Owen Western
• Gabriela Weston, LCSW-C
• Timothy Westrom, RPH
• Cory Wharton, LGSW
• Rodney Thomas Whetstone, CRNA

• Specialist in Cumberland, MD
• Providers in Cumberland, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.