NPIMap

Organization Active NPI

Cabarrus Diagnostic Imaging LLC

Doing business as Novant Health Imaging Cabarrus

  • Diagnostic Radiology Physician
  • Charlotte, NC
National Provider Identifier
1376591545
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CABARRUS DIAGNOSTIC IMAGING LLC
Doing business as
Novant Health Imaging Cabarrus
Practice address
13460 Plaza Road Ext Ste 150
Charlotte, NC 28215-8923
Phone
(704) 262-9885
NPI assigned
May 4, 2006
Last updated
Mar 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Authorized official

Name
Mr. Geoffrey K. Gardner
Title
SVP Finance and Revenue Cycle
Phone
(336) 718-2078

Specialties & licenses 1

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

Addresses

Primary practice location

13460 Plaza Road Ext Ste 150
Charlotte, NC 28215-8923

Mailing address

PO Box 603543
Charlotte, NC 28260-3543
Phone (678) 393-5600

Other identifiers 4

IdentifierTypeStateIssuer
470001082OtherMEDICARE RR
89012ANMedicaidNC
166146500OtherNCDOL
012ANOtherNCBCBS NC

Other names 1

  • Novant Health Imaging Cabarrus Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040504001237 NC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4486642881 Practice locations: Charlotte, NC

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1026376Novant Health Imaging Cabarrus13460 Plaza Road, Suite 150, Charlotte, NC 28215Certificate of waiverMar 10, 2028

National Provider Directory

National Provider Directory

Member of 1

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

Locations

925 Bradley St NE
Concord, NC 28025
Phone (704) 262-9885

Practitioners & affiliated clinicians

Practitioners 8

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": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1376591545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603543",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603543",
            "telephone_number": "678-393-5600",
            "fax_number": "770-300-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 PLAZA ROAD EXT STE 150",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282158923",
            "telephone_number": "704-262-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CABARRUS DIAGNOSTIC IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "SVP FINANCE AND REVENUE CYCLE",
        "authorized_official_telephone_number": "336-718-2078",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "470001082",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012AN",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "166146500",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "012AN",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Imaging Cabarrus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.