NPIMap

Organization Active NPI

Green Bay Radiology SC

  • Diagnostic Radiology Physician
  • Green Bay, WI
National Provider Identifier
1447327986
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
GREEN BAY RADIOLOGY SC
Practice address
2941 S Ridge Rd
Green Bay, WI 54304-5517
Phone
(920) 336-4096
Fax
(920) 336-8093
NPI assigned
Nov 29, 2006
Last updated
May 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Authorized official

Name
Jimmy Dado Jr.
Title
Director of Revenue Cycle
Phone
(614) 325-8899

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X WI Primary
Vascular & Interventional Radiology Physician 2085R0204X WI

Addresses

Primary practice location

2941 S Ridge Rd
Green Bay, WI 54304-5517

Mailing address

2941 S Ridge Rd
Green Bay, WI 54304-5517
Phone (920) 336-4096

Other identifiers 1

IdentifierTypeStateIssuer
32692400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI, MN, TX, IL, DC6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20040525000803 WI Part B Supplier - Clinic/Group Practice 7113908310 Receives reassigned benefits from 25 practitioners
Practice locations: Green Bay, WI; Oconto Falls, WI; Marinette, WI; Appleton, WI
O20220504001464 MI Part B Supplier - Clinic/Group Practice 7113908310 Receives reassigned benefits from 1 practitioner
Practice locations: Bloomfield Hills, MI
O20231114003097 MN Part B Supplier - Clinic/Group Practice 7113908310 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Paul, MN
O20240118002595 TX Part B Supplier - Clinic/Group Practice 7113908310 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX
O20240314000576 IL Part B Supplier - Clinic/Group Practice 7113908310 Receives reassigned benefits from 1 practitioner
Practice locations: Skokie, IL
O20240806003794 DC Part B Supplier - Clinic/Group Practice 7113908310 Receives reassigned benefits from 1 practitioner
Practice locations: Potomac, MD

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780012800000",
    "number": "1447327986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2941 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045517",
            "telephone_number": "920-336-4096",
            "fax_number": "920-336-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2941 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045517",
            "telephone_number": "920-336-4096",
            "fax_number": "920-336-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN BAY RADIOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A",
        "authorized_official_last_name": "DADO",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "614-325-8899",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32692400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.