North Shore MRI LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

NORTH SHORE MRI LLC

Practice address

19300 N 4TH St
Suite B
Covington, LA 70433-8720

Phone

(985) 871-6655

Fax

(985) 871-5050

NPI assigned

Jul 15, 2005

Last updated

Feb 15, 2008By 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

James W. Holmes

Title

Chief Operating Officer

Phone

(337) 291-9161

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1457350076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19300 N 4TH ST",
            "address_2": "SUITE B",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338720",
            "telephone_number": "985-871-6655",
            "fax_number": "985-871-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19300 N 4TH ST",
            "address_2": "SUITE B",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338720",
            "telephone_number": "985-871-6655",
            "fax_number": "985-871-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE MRI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "337-291-9161"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1442054",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Covington, LA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.