NPIMap

Organization Active NPI

Northeast Missouri Imaging Associates, Inc.

  • Diagnostic Radiology Physician
  • Hannibal, MO
National Provider Identifier
1356309306
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTHEAST MISSOURI IMAGING ASSOCIATES, INC.
Practice address
6000 Hospital Drive
Hannibal, MO 63401
Phone
(573) 221-7870
Fax
(573) 221-9323
NPI assigned
May 1, 2006
Last updated
Sep 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official

Name
Brandon Selle
Title
Administrator
Phone
(573) 221-7870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

6000 Hospital Drive
Hannibal, MO 63401

Mailing address

PO Box 861
Hannibal, MO 63401-0861
Phone (573) 221-7870

Other identifiers 2

IdentifierTypeStateIssuer
137441OtherMOHEALTHLINK
1040OtherMOANTHEM BLUE CROSS

Other names 1

  • Hannibal Imaging Associates, Inc. Former legal business name

National Provider Directory

National Provider Directory

Locations

2910 Saint Marys Ave
Hannibal, MO 63401
Phone (573) 221-0996

1000 Webster St
Mexico, MO 65265
Phone (573) 581-2348

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1356309306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 861",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634010861",
            "telephone_number": "573-221-7870",
            "fax_number": "573-221-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 HOSPITAL DRIVE",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "63401",
            "telephone_number": "573-221-7870",
            "fax_number": "573-221-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST MISSOURI IMAGING ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "SELLE",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-221-7870"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "137441",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "1040",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hannibal Imaging Associates, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.