Active NPI
Great River Radiology, Inc
- Diagnostic Radiology Physician
- Granite City, IL
National Provider Identifier
1407412752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- GREAT RIVER RADIOLOGY, INC
- Practice address
- 2100 Madison Ave
Granite City, IL 62040 - Phone
- (618) 798-3281
- NPI assigned
- May 13, 2019
- Last updated
- May 13, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Zabrowski, MD
- Title
- President
- Phone
- (314) 303-9484
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
2100 Madison Ave
Granite City, IL 62040
Mailing address
739 Pinehurst Drive
New Braunfels, TX 78130
National Provider Directory
National Provider DirectoryLocations
4273 S State Route 159
Glen Carbon, IL 62034
Phone (618) 288-2297
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557705600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1557705600000",
"number": "1407412752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "739 PINEHURST DRIVE",
"city": "NEW BRAUNFELS",
"state": "TX",
"postal_code": "78130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 MADISON AVE",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "62040",
"telephone_number": "618-798-3281"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREAT RIVER RADIOLOGY, INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-13",
"last_updated": "2019-05-13",
"status": "A",
"authorized_official_last_name": "ZABROWSKI",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "314-303-9484",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Granite City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.