Northland Radiology Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

NORTHLAND RADIOLOGY INC

Practice address

20905 Greenfield Rd
Ste 105
Southfield, MI 48075-5344

Phone

(248) 569-0296

Fax

(248) 569-3390

NPI assigned

Jun 6, 2006

Organization subpart

No

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

Authorized official

Name

Prakash Gandhi

Title

Administrator

Phone

(248) 827-7200

Specialties & licenses 14

Addresses

Other identifiers 1

Tax ID family

Northland Radiology Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Northland Radiology Inc

  • Diagnostic Radiology Physician
  • Southfield, MI
  • NPI 1386804060
  NPD tax ID
• Northland Radiology Inc.

  • Physical Medicine & Rehabilitation Physician
  • Southfield, MI
  • NPI 1225652993
  NPD tax ID

Locations

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384300800000",
    "number": "1427097252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26222 TELEGRAPH RD",
            "address_2": "STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480335318",
            "telephone_number": "248-827-7200",
            "fax_number": "248-827-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD",
            "address_2": "STE 105",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755344",
            "telephone_number": "248-569-0296",
            "fax_number": "248-569-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND RADIOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-11-13",
        "status": "A",
        "authorized_official_last_name": "GANDHI",
        "authorized_official_first_name": "PRAKASH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-827-7200"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0902X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0F37368",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.