Organization Active NPI

Tri-State Radiology, PC

  • Diagnostic Radiology Physician
  • Cumberland, MD
National Provider Identifier
1386730331
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
TRI-STATE RADIOLOGY, PC
Practice address
900 Seton Dr
Department of Radiology
Cumberland, MD 21502-1854
Phone
(301) 723-5581
Fax
(301) 723-5745
NPI assigned
Oct 5, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. John Nickolas Pappas, MD
Title
Treasurer
Phone
(301) 723-5581

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Locations

915 Bishop Walsh Rd
Lavale, MD 21502
Phone (301) 724-7277

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

NPPES NPI Registry

Primary practice location

900 Seton Dr
Department of Radiology
Cumberland, MD 21502-1854

Mailing address

PO Box 3206
Lavale, MD 21504-3206
Phone (301) 723-5581

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0010353000MedicaidWV

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 15, 2008.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1386730331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3206",
            "city": "LAVALE",
            "state": "MD",
            "postal_code": "215043206",
            "telephone_number": "301-723-5581",
            "fax_number": "301-723-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SETON DR",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215021854",
            "telephone_number": "301-723-5581",
            "fax_number": "301-723-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE RADIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "PAPPAS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "NICKOLAS",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "301-723-5581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010353000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

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