Broad 64 Imaging LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

BROAD 64 IMAGING LLC

Practice address

6605 W Broad St
Suite B - Ground Floor
Richmond, VA 23230

Phone

(804) 281-0215

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Kimberly Ralston

Title

System Director

Phone

(419) 996-5119

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Bon Secours-St. Mary's Hospital of Richmond, Inc.

  dba Bon Secours Cure and Care

  • Family Medicine Physician
  • Richmond, VA
  • NPI 1205116886

  Member Of

  NPD member
• Harness Health Pharmacy - Virginia LLC

  dba Harness Health Pharmacy #500

  • Community/Retail Pharmacy
  • Richmond, VA
  • NPI 1427139716

  Member Of

  NPD member

Practitioners 1

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

• David P Ekey, MD

  • Diagnostic Radiology Physician
  • Richmond, VA
  • NPI 1235109018
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1316015985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631146",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631146",
            "telephone_number": "513-952-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 W BROAD ST",
            "address_2": "SUITE B - GROUND FLOOR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23230",
            "telephone_number": "804-281-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD 64 IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR",
        "authorized_official_telephone_number": "419-996-5119"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madilynn Brito
• Pauleatha Ciara Britt, FNP
• Chantelle Victoria Britton
• Meredith E. Britton, ACNP
• Jacqueline Britz
• Broad Rock Counseling and Training Associates
• Reuben Hancock Broaddus Jr., M.D.
• William C Broaddus, M.D., PH.D.
• Abigail Elizabeth Broadhurst, OTR/L
• Monica D Broadnax, FNP-C

• Radiology Clinic/Center in Richmond, VA
• Providers in Richmond, VA by specialty
• Radiology Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.