Great River Radiology, Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

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

Organization subpart

No

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

Addresses

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": []
}

• Granite City Psychiatry LLC
• Granite City Urgent Care Walk-in Clinic
• Granite City Vision Ctr Inc
• Granite City Vision, Inc.
• Granite Nursing and Rehabilitation Center, LLC
• Greg Jones
• Angela Marie Gregory
• Walter P Griffith, P.T.
• Samuel W Guithues, OT
• Karl Raymond Gundersen, MD

• Diagnostic Radiology Physician in Granite City, IL
• Providers in Granite City, IL by specialty
• Diagnostic Radiology Physician in Illinois

• 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.

Verify at the official NPI Registry.