Individual provider Active NPI

Andrea Villaraus

  • Magnetic Resonance Imaging Radiologic Technologist
  • Salisbury, NC
National Provider Identifier
1407095698
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging Radiologic TechnologistTaxonomy code 2471M1202X
License
347461
Practice address
1601 Brenner Ave
Salisbury, NC 28144-2515
Phone
(704) 638-9000
NPI assigned
Feb 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X CRT 52248 FL
Radiologic Technologist 247100000X RHT82449 CA
Radiologic Technologist 247100000X 09370 MA
Magnetic Resonance Imaging Radiologic Technologist 2471M1202X 347461 Primary

Addresses

Primary practice location

1601 Brenner Ave
Salisbury, NC 28144-2515

Mailing address

4139 SW 66TH Way
Davie, FL 33314-3345
Phone (954) 668-5513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RHT82449CAMDRadiologic Technologist
CRT 52248FLMDRadiologic Technologist
09370MAMDRadiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234310400000",
    "number": "1407095698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4139 SW 66TH WAY",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143345",
            "telephone_number": "954-668-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRENNER AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442515",
            "telephone_number": "704-638-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARAUS",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "FL",
            "license": "CRT 52248",
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "CA",
            "license": "RHT82449",
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "MA",
            "license": "09370",
            "primary": false
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": null,
            "license": "347461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.