NPIMap

Organization Active NPI

Ossp Imaging of St. Louis

  • Radiology Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1417534918
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
OSSP IMAGING OF ST. LOUIS
Practice address
12401 Olive Blvd
Saint Louis, MO 63141-5443
Phone
(314) 390-0135
NPI assigned
Mar 29, 2021
Organization subpart
Yes
Parent organization
ORTHO SPORT AND SPINE PHYSICIANS DAWSONVILLEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Ra'Keshia Brogdon
Title
Credentialing Specialist
Phone
(404) 941-1233

Specialties & licenses 1

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

Addresses

Primary practice location

12401 Olive Blvd
Saint Louis, MO 63141-5443

Mailing address

5788 Roswell Rd
Atlanta, GA 30328-4904
Phone (305) 290-2448

National Provider Directory

National Provider Directory
Tax ID family
Ortho Sport Spine Physicians25 organizations share this tax ID, including this one
Part of
Ortho Sport and Spine Physicians Pooler

Other organizations with this tax ID 24

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

View all 24

Locations

12401 Olive Blvd
Saint Louis, MO 63141
Phone (314) 390-0135

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1417534918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5788 ROSWELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284904",
            "telephone_number": "305-290-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415443",
            "telephone_number": "314-390-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSSP IMAGING OF ST. LOUIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHO SPORT AND SPINE PHYSICIANS DAWSONVILLE",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "BROGDON",
        "authorized_official_first_name": "RA'KESHIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "404-941-1233"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.