NPIMap

Organization Active NPI

Ultra Imaging of Tampa LLC

  • Diagnostic Radiology Physician
  • Lakeland, FL
National Provider Identifier
1477544401
Registry record updated Aug 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ULTRA IMAGING OF TAMPA LLC
Practice address
2946 Lakeland Highlands Rd
Highlands Plaza
Lakeland, FL 33803-4379
Phone
(863) 583-1674
Fax
(863) 583-1678
NPI assigned
Oct 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2007

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

Authorized official

Name
Mr. Lavelle R Hardin
Title
Credentialing Coordinator
Phone
(615) 344-8203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

2946 Lakeland Highlands Rd
Highlands Plaza
Lakeland, FL 33803-4379

Mailing address

2946 Lakeland Highlands Rd
Highlands Plaza
Lakeland, FL 33803-4379
Phone (863) 583-1674

Other names 1

  • dba Ultra Imaging of Lakeland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dba Ultra Imaging of Lakeland9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186012800000",
    "number": "1477544401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2946 LAKELAND HIGHLANDS RD",
            "address_2": "HIGHLANDS PLAZA",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034379",
            "telephone_number": "863-583-1674",
            "fax_number": "863-583-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 LAKELAND HIGHLANDS RD",
            "address_2": "HIGHLANDS PLAZA",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034379",
            "telephone_number": "863-583-1674",
            "fax_number": "863-583-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRA IMAGING OF TAMPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-08-02",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "LAVELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "615-344-8203",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Ultra Imaging of Lakeland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2007; 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.