Indiana MRI of Terre Haute, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

INDIANA MRI OF TERRE HAUTE, LLC

Practice address

4313 S 7TH St
Terre Haute, IN 47802-4365

Phone

(812) 234-0555

Fax

(812) 235-2973

NPI assigned

Oct 13, 2006

Last updated

Apr 3, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Owen Lauer

Title

Managing Member

Phone

(812) 336-0056

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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.

• Susan Audrey Koslow, MD

  • Diagnostic Radiology Physician
  • Terre Haute, IN
  • NPI 1720007933
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1447340351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 S WALNUT ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474017393",
            "telephone_number": "812-336-0056",
            "fax_number": "812-336-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4313 S 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024365",
            "telephone_number": "812-234-0555",
            "fax_number": "812-235-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA MRI OF TERRE HAUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "LAUER",
        "authorized_official_first_name": "OWEN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "812-336-0056"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100473160A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000221954",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Indiana Eye Specialists
• Indiana Eye Specialists, LLC
• Indiana Hearing LLC (Miracle Ear)
• Indiana Medical Services, LLC (Body In Motion)
• Indiana Medical Specialists, Inc
• Indiana State University
• Indiana State University (ISU Psychology Clinic-Faculty Practice Svcs)
• Indiana West, PC
• Indianapolis Vamc
• Indianapolis Vamc

• Radiology Clinic/Center in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Radiology Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.