Organization Active NPI

Live Radiology, LLC

  • Radiology Clinic/Center
  • Frederick, MD
National Provider Identifier
1417131467
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
M369 Issued in MD
Legal business name
LIVE RADIOLOGY, LLC
Practice address
176 Thomas Johnson Dr
Suite 103
Frederick, MD 21702-4410
Phone
(301) 694-2630
Fax
(301) 694-2307
NPI assigned
Dec 27, 2007
Last updated
Dec 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Authorized official

Name
Mr. William Bonde
Title
Managing Member
Phone
(301) 694-2630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X M369 MD Primary

Addresses

Primary practice location

176 Thomas Johnson Dr
Suite 103
Frederick, MD 21702-4410

Mailing address

176 Thomas Johnson Dr
Suite 103
Frederick, MD 21702-4410
Phone (301) 694-2630

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1417131467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 THOMAS JOHNSON DR",
            "address_2": "SUITE 103",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024410",
            "telephone_number": "301-694-2630",
            "fax_number": "301-694-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 THOMAS JOHNSON DR",
            "address_2": "SUITE 103",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024410",
            "telephone_number": "301-694-2630",
            "fax_number": "301-694-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE RADIOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "BONDE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "301-694-2630",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "MD",
            "license": "M369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.