Organization Active NPI

Norwich Diagnostic Imaging Associates P.C

  • Diagnostic Radiology Physician
  • Norwich, CT
National Provider Identifier
1407833908
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORWICH DIAGNOSTIC IMAGING ASSOCIATES P.C
Practice address
326 Washington St
Norwich, CT 06360-2740
Phone
(860) 889-8331
NPI assigned
Dec 27, 2005
Last updated
Feb 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

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

Authorized official

Name
Phillip Kohanski, MDNPI 1578559225
Title
President
Phone
(800) 927-0002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X CT Primary

Addresses

Primary practice location

326 Washington St
Norwich, CT 06360-2740

Mailing address

PO Box 9132
Brookline, MA 02446-9132
Phone (800) 927-0002

Other identifiers 1

IdentifierTypeStateIssuer
004089448MedicaidCT

National Provider Directory

National Provider Directory

Locations

111 Salem Tpke
Norwich, CT 06360
Phone (860) 425-5900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518566400000",
    "number": "1407833908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9132",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024469132",
            "telephone_number": "800-927-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 WASHINGTON ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602740",
            "telephone_number": "860-889-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORWICH DIAGNOSTIC IMAGING ASSOCIATES P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2018-02-14",
        "status": "A",
        "authorized_official_last_name": "KOHANSKI",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-927-0002",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004089448",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; 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.