Diagnostic Imaging Specialists, P.a.

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

DIAGNOSTIC IMAGING SPECIALISTS, P.A.

Practice address

2019 S 6TH St
Brainerd, MN 56401-4528

Phone

(218) 822-4242

Fax

(218) 822-3758

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Charles Benson, M.D.

Title

President

Phone

(218) 828-4242

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447271192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014528",
            "telephone_number": "218-822-4242",
            "fax_number": "218-822-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014528",
            "telephone_number": "218-822-4242",
            "fax_number": "218-822-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC IMAGING SPECIALISTS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-828-4242",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "172079",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "01010253",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Dehen, MD
• James W Delong, M.D.
• Kevin William Dens, DDS
• Tammy Lynn Derosier
• Vishnuteja V Devalla, M.D.
• Danette Lee Diethert, PMHNP
• Discovery Woods Montessori
• Catherine Disterhaupt, LPCC
• Shawn Rae Disterhaupt
• Marci Marie Douts, LPCC

• Radiology Clinic/Center in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Radiology Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.