NPIMap

Organization Active NPI

West Boynton Beach Open Imaging Center LLC

  • Diagnostic Radiology Physician
  • Boynton Beach, FL
National Provider Identifier
1376711309
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
WEST BOYNTON BEACH OPEN IMAGING CENTER LLC
Practice address
10151 Enterprise Center Blvd
Suite 109
Boynton Beach, FL 33437-3759
Phone
(561) 752-5050
Fax
(561) 364-5606
NPI assigned
Feb 12, 2008
Last updated
May 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Authorized official

Name
Wanda Fogarty
Title
VP Imaging Services
Phone
(561) 838-3630

Specialties & licenses 1

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

Addresses

Primary practice location

10151 Enterprise Center Blvd
Suite 109
Boynton Beach, FL 33437-3759

Mailing address

10151 Enterprise Center Blvd
Suite 109
Boynton Beach, FL 33437-3759
Phone (561) 752-5050

Other identifiers 2

IdentifierTypeStateIssuer
000260600MedicaidFL
V3267OtherFLBCBS OF FL

National Provider Directory

National Provider Directory

Locations

10151 Entrprs Cntr Blvd
Ste 109
Boynton Beach, FL 33437
Phone (561) 600-3019

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274140800000",
    "number": "1376711309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10151 ENTERPRISE CENTER BLVD",
            "address_2": "SUITE 109",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373759",
            "telephone_number": "561-752-5050",
            "fax_number": "561-364-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 ENTERPRISE CENTER BLVD",
            "address_2": "SUITE 109",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373759",
            "telephone_number": "561-752-5050",
            "fax_number": "561-364-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BOYNTON BEACH OPEN IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2010-05-18",
        "status": "A",
        "authorized_official_last_name": "FOGARTY",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "VP IMAGING SERVICES",
        "authorized_official_telephone_number": "561-838-3630"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000260600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "V3267",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.