Radiology Associates of San Luis Obispo

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO

Doing business as

Sierra Vista Regional Medical Center

Practice address

1010 Murray Ave
San Luis Obispo, CA 93405-8800

Phone

(805) 461-7080

Fax

(805) 464-0243

NPI assigned

Feb 22, 2007

Last updated

Dec 5, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

RADIOLOGY ASSOCIATES OF SAN LUIS OBISPOAs reported in NPPES

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

Authorized official

Name

Dr. William M. Russell, M.D.NPI 1104892454

Title

Managing Partner

Phone

(805) 461-7080

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sierra Vista Regional Medical Center Doing business as

Part of

Radiology Assoc of S L

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Radiology Associates of San Luis Obispo

  • Diagnostic Radiology Physician
  • Atascadero, CA
  • NPI 1063612570
  NPPES parent name

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.

• William M. Russell, MD

  • Diagnostic Radiology Physician
  • Templeton, CA
  • NPI 1104892454
  Authorized official Same address or phone

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1427183508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2920",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934232920",
            "telephone_number": "805-461-7080",
            "fax_number": "805-464-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MURRAY AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934058800",
            "telephone_number": "805-461-7080",
            "fax_number": "805-464-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "805-461-7080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0009770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sierra Vista Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen A Quist, DDS
• R Jeffrey Herten MD Inc
• Crystal Elaine Racicot
• Radiological Associates Medical Group, Inc
• Radiology Associates of San Luis Obispo (French Hospital Medical Center)
• Radiology Associates of San Luis Obispo (MRI of San Luis Obispo)
• Deepa Ragesh Panikkath, MD
• Bruce D Ragsdale, M.D.
• Mary Alice Raia
• Elena C Rains

• Radiology Clinic/Center in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.