NPIMap

Organization Active NPI

American Health Imaging of South Carolina, LLC

Doing business as American Health Imaging of Columbia

  • Radiology Clinic/Center
  • Columbia, SC
National Provider Identifier
1477123271
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
AMERICAN HEALTH IMAGING OF SOUTH CAROLINA, LLC
Doing business as
American Health Imaging of Columbia
Practice address
1241 Assembly St Ste B
Columbia, SC 29201-3121
Phone
(803) 766-3009
NPI assigned
Jun 25, 2021
Last updated
Jul 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Authorized official

Name
Katrina Roelle
Title
Director of Credentialing
Phone
(614) 689-1691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1241 Assembly St Ste B
Columbia, SC 29201-3121

Mailing address

PO Box 745973
Atlanta, GA 30374-5973

Other names 1

  • American Health Imaging of Columbia Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220118000418 SC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2062813413 Practice locations: Columbia, SC

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2249572American Health Imaging of Columbia1241 Assembly Street, Suite B, Columbia, SC 29201Certificate of waiverJan 20, 2028

National Provider Directory

National Provider Directory
Tax ID family
American Health Imaging of South Carolina LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1245 Lake Murray Blvd
#B
Irmo, SC 29063
Phone (803) 766-3005

Practitioners & affiliated clinicians

Practitioners 47

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 47

NPI Registry JSON

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1477123271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 745973",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303745973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 ASSEMBLY ST STE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013121",
            "telephone_number": "803-766-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN HEALTH IMAGING OF SOUTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-25",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "ROELLE",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "614-689-1691"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Health Imaging of Columbia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "American Health Imaging of Columbia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.