NPIMap

Organization Active NPI

Sentara Advanced Imaging Solutions, LLC

Doing business as Sentara Advanced Imaging Solutions

  • Diagnostic Radiology Physician
  • Elizabeth City, NC
National Provider Identifier
1437805280
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SENTARA ADVANCED IMAGING SOLUTIONS, LLC
Doing business as
Sentara Advanced Imaging Solutions
Practice address
1144 N Road St
Elizabeth City, NC 27909-3473
Phone
(252) 435-1295
Fax
(855) 939-7154
NPI assigned
Mar 1, 2022
Last updated
Jun 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Doris Prince
Title
Director
Phone
(757) 983-5475

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

1144 N Road St
Elizabeth City, NC 27909-3473

Mailing address

1144 N Road St
Elizabeth City, NC 27909-3473
Phone (252) 435-1295

Other practice location 1

446 Caratoke Hwy
Moyock, NC 27958-8672
Phone (757) 983-1000

Other names 1

  • SENTARA ADVANCED IMAGING SOLUTIONS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240321000273 NC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7113327545 Practice locations: Elizabeth City, NC

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Sentara Advanced Imaging Solutions7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

3050 Halstead Blvd Ext
Elizabeth Cty, NC 27909
Phone (252) 334-0402

Practitioners & affiliated clinicians

Practitioners 71

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.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1437805280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 N ROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093473",
            "telephone_number": "252-435-1295",
            "fax_number": "855-939-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 N ROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093473",
            "telephone_number": "252-435-1295",
            "fax_number": "855-939-7154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "446 Caratoke Hwy",
            "address_purpose": "LOCATION",
            "city": "Moyock",
            "state": "NC",
            "postal_code": "279588672",
            "country_code": "US",
            "telephone_number": "757-983-1000",
            "fax_number": "855-939-7154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SENTARA ADVANCED IMAGING SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-983-5475"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SENTARA ADVANCED IMAGING SOLUTIONS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SENTARA ADVANCED IMAGING SOLUTIONS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.