Organization Active NPI

Open Advanced MRI Longview LLC

  • Diagnostic Radiology Physician
  • Longview, WA
National Provider Identifier
1316992720
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
OPEN ADVANCED MRI LONGVIEW LLC
Practice address
1015 Ocean Beach Hwy
#125
Longview, WA 98632-4098
Phone
(360) 703-0703
Fax
(360) 703-0704
NPI assigned
May 23, 2006
Last updated
Aug 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Authorized official

Name
Levent Adam
Title
Director of Operations
Phone
(503) 407-4697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

1015 Ocean Beach Hwy
#125
Longview, WA 98632-4098

Mailing address

PO Box 75025
Baltimore, MD 21275-5025
Phone (503) 657-8663

Other identifiers 2

IdentifierTypeStateIssuer
286358MedicaidOR
7110620MedicaidWA

National Provider Directory

National Provider Directory

Locations

1015 Ocean Beach Hwy
Ste 125
Longview, WA 98632
Phone (360) 703-0703

221G NE 104th Ave
Ste 10
Vancouver, WA 98664
Phone (360) 703-0703

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1316992720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75025",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212755025",
            "telephone_number": "503-657-8663",
            "fax_number": "503-723-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 OCEAN BEACH HWY",
            "address_2": "#125",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324098",
            "telephone_number": "360-703-0703",
            "fax_number": "360-703-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN ADVANCED MRI LONGVIEW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "ADAM",
        "authorized_official_first_name": "LEVENT",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "503-407-4697"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286358",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7110620",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.