NPIMap

Organization Active NPI

Med Tel International Corporation

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Pueblo, CO
National Provider Identifier
1306970017
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
MED TEL INTERNATIONAL CORPORATION
Practice address
1630 Fortino Blvd
Pueblo, CO 81008-1856
Phone
(719) 543-8300
Fax
(719) 543-8306
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Thompson S Dent
Title
Ceo
Phone
(615) 236-4640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary

Addresses

Primary practice location

1630 Fortino Blvd
Pueblo, CO 81008-1856

Mailing address

1430 Spring Hill Rd
Suite 500
McLean, VA 22102-3000
Phone (703) 287-4189

Other identifiers 1

IdentifierTypeStateIssuer
91406285MedicaidCO

Other names 1

  • Wide Open MRI Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Med-Tel Intrntl Corp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1430 Spring Hill Rd
Ste 500
McLean, VA 22102

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306970017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 SPRING HILL RD",
            "address_2": "SUITE 500",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221023000",
            "telephone_number": "703-287-4189",
            "fax_number": "703-448-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 FORTINO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081856",
            "telephone_number": "719-543-8300",
            "fax_number": "719-543-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED TEL INTERNATIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DENT",
        "authorized_official_first_name": "THOMPSON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-236-4640"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91406285",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wide Open MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.