Camellia Imaging LLC
Organization Active NPI Diagnostic Radiology Physician · Hoover, AL
NPI 1316495997 · NPPES record last updated Jan 18, 2017
Key facts
- NPI
- 1316495997
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- MD.30928 (AL)
- Legal business name
- CAMELLIA IMAGING LLC
- Practice address
- 2068 Valleydale Rd
Hoover, AL 35244-2092 - Phone
- (205) 544-2828
- Fax
- (205) 267-0192
- NPI assigned
- Sep 13, 2016
- Organization subpart
- No
Authorized official
- Name
- Monika Tataria, M.D.
- Title
- President
- Phone
- (205) 544-2828
Practitioners 3
-
Monika Tataria, M.D.
-
Stephanie L Denham, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170120001516 | AL | Part B Supplier - Mammography Center | 3779865035 | Practice locations: Birmingham, AL |
| O20171212001159 | AL | Part B Supplier - Clinic/Group Practice | 3779865035 |
Receives reassigned benefits from 3 practitioners Practice locations: Hoover, AL |
National Provider Directory
Locations
2068 Valleydale Rd
Hoover, AL 35244
Phone (205) 444-1167
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | MD.30928 | AL | Yes |
Addresses
Primary practice location
2068 Valleydale Rd
Hoover, AL 35244-2092
Mailing address
2068 Valleydale Rd
Hoover, AL 35244-2092
Phone (205) 544-2828
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750597670 | Other | INDIVIDUAL NPI |
Other providers in Hoover, AL
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- Kerry 'Craig' Caines
- Scott E Caldwell
- Dorinda Fay Cale
- Donald Davis Campbell III
- Emileigh Ruth Campbell
- Amanda Myers Campos
- Sadie Jane Cancilla
- Emily Cantrell
All providers in Hoover, AL · Diagnostic Radiology Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.