St. Christopher'S Imaging, LLC
Organization Active NPI Portable X-ray and/or Other Portable Diagnostic Imaging Supplier · Shreveport, LA
NPI 1457741852 · NPPES record last updated Jun 15, 2015
Key facts
- NPI
- 1457741852
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X
- Legal business name
- ST. CHRISTOPHER'S IMAGING, LLC
- Practice address
- 1725 Elizabeth Ave
Shreveport, LA 71101-4502 - Phone
- (318) 658-9637
- Fax
- (318) 425-9189
- NPI assigned
- Jan 23, 2015
- Organization subpart
- Yes
- Parent organization (as reported)
- ST. CHRISTOPHER'S IMAGING, LLC
Authorized official
- Name
- Mr. Christopher A Santora, RDMS,RVT,ARRT
- Title
- Managing Partner
- Phone
- (318) 658-9637
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 29
-
Jessica Caraway, MD
-
Brenton Wayne McDonald, M.D.
-
Chad Thomas Porter, M.D.
-
Marcus Villery Stelly, M.D.
-
Jennifer Benjamin, D.O.
-
Matthew K Dang, M.D.
-
Morgan Haile, M.D.
-
Michael K. Herron, M. D.
-
Justin Hung Pham, M.D.
-
Sameh Adel Sakla, M.D.
-
Manash K Sarcar, MD
-
Matthew H. Smith, MD
-
Ryan K Tompkins, MD
-
Ronald R Winters, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130812000199 | LA | Part B Supplier - Portable X-Ray Supplier | 2062694458 |
Receives reassigned benefits from 25 practitioners 1 other NPI on this enrollment Practice locations: Shreveport, LA |
National Provider Directory
- Tax ID family
- St Christophers Imaging LLC
- Part of
- St Christophers Imaging LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 335V00000X | 01957841 | LA | |
| Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 335V00000X | LA | Yes |
Addresses
Primary practice location
1725 Elizabeth Ave
Shreveport, LA 71101-4502
Mailing address
1725 Elizabeth Ave
Shreveport, LA 71101-4502
Phone (318) 658-9637
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2158554 | Medicaid | LA |
Other providers in Shreveport, LA
- Aldera Square
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- St. Christopher'S Imaging, LLC
- St. Christopher'S Imaging, LLC
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- St. Genevive Health Care Services, Inc.
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All providers in Shreveport, LA · Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.