NPIMap

Organization Active NPI

Radiology Associates of Tallahassee PA

  • Diagnostic Radiology Physician
  • Tallahassee, FL
National Provider Identifier
1407686777
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY ASSOCIATES OF TALLAHASSEE PA
Practice address
410 W Tennessee St
Tallahassee, FL 32301-1026
Phone
(423) 826-1286
NPI assigned
Aug 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Authorized official

Name
John R Detelich
Title
Ceo
Phone
(850) 878-4127

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X

Addresses

Primary practice location

410 W Tennessee St
Tallahassee, FL 32301-1026

Mailing address

PO Box 20747
Tampa, FL 33622-0747
Phone (800) 475-6112

National Provider Directory

National Provider Directory
Tax ID family
Radiology Associates of6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1407686777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20747",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336220747",
            "telephone_number": "800-475-6112",
            "fax_number": "706-653-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W TENNESSEE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323011026",
            "telephone_number": "423-826-1286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF TALLAHASSEE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "DETELICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-878-4127"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.