NPIMap

Organization Active NPI

North Jefferson Imaging, LLC

  • Diagnostic Radiology Physician
  • Gardendale, AL
National Provider Identifier
1467490920
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTH JEFFERSON IMAGING, LLC
Practice address
2217 Decatur Hwy
Suite 115
Gardendale, AL 35071-2301
Phone
(205) 418-1280
Fax
(205) 418-1281
NPI assigned
Jun 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Charles Michael Mead, MDNPI 1205833761
Title
President
Phone
(205) 418-1280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

2217 Decatur Hwy
Suite 115
Gardendale, AL 35071-2301

Mailing address

2000A Southbridge Pkwy
Ste 300
Birmingham, AL 35209-7704
Phone (205) 871-4274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051222000710 AL Part B Supplier - Clinic/Group Practice 3274555859 Receives reassigned benefits from 16 practitioners
Practice locations: Gardendale, AL

National Provider Directory

National Provider Directory

Locations

2217 Decatur Hwy
Ste 101
Gardendale, AL 35071
Phone (205) 418-1200

2217 Decatur Hwy
Ste 115
Gardendale, AL 35071
Phone (205) 418-1280

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467490920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000A SOUTHBRIDGE PKWY",
            "address_2": "STE 300",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352097704",
            "telephone_number": "205-871-4274",
            "fax_number": "205-871-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 DECATUR HWY",
            "address_2": "SUITE 115",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350712301",
            "telephone_number": "205-418-1280",
            "fax_number": "205-418-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JEFFERSON IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEAD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-418-1280",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardendale, AL

Sources for this page

  • 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.
  • 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.