Organization Active NPI

Tri-County Radiologists, Inc.

  • Diagnostic Radiology Physician
  • Newark, OH
National Provider Identifier
1477544880
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
TRI-COUNTY RADIOLOGISTS, INC.
Practice address
2112 Cherry Valley Rd
Newark, OH 43055-1323
Phone
(740) 522-3774
Fax
(740) 522-2221
NPI assigned
Nov 3, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Authorized official

Name
Mrs. Carolyn J Watson
Title
Business Manager
Phone
(740) 522-3774

Specialties & licenses 1

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

Addresses

Primary practice location

2112 Cherry Valley Rd
Newark, OH 43055-1323

Mailing address

2112 Cherry Valley Rd
P O Box 948
Newark, OH 43055-1323
Phone (740) 522-3774

Other identifiers 1

IdentifierTypeStateIssuer
0139960MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CO, PA, IL, MO, KS, MI, AZ, UT, CA, FL11 enrollments

Enrollment records 11

Enrollment IDStateProvider typePAC IDDetails
O20050207000073 OH Part B Supplier - Clinic/Group Practice 0840241907 Receives reassigned benefits from 18 practitioners
Practice locations: Westerville, OH; Worthington, OH; Newark, OH; New Albany, OH; Galena, OH; Dublin, OH; Columbus, OH; Cleveland, OH…
O20250306001136 CO Part B Supplier - Clinic/Group Practice 0840241907 Receives reassigned benefits from 1 practitioner
Practice locations: Montrose, CO
O20250306001283 PA Part B Supplier - Clinic/Group Practice 0840241907 Receives reassigned benefits from 1 practitioner
Practice locations: Coraopolis, PA
O20250307000748 IL Part B Supplier - Clinic/Group Practice 0840241907 Receives reassigned benefits from 1 practitioner
Practice locations: Naperville, IL
O20250312003690 MO Part B Supplier - Clinic/Group Practice 0840241907 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO
O20250313000665 KS Part B Supplier - Clinic/Group Practice 0840241907 Receives reassigned benefits from 1 practitioner
Practice locations: Wichita, KS
O20250313000983 MI Part B Supplier - Clinic/Group Practice 0840241907 Receives reassigned benefits from 1 practitioner
Practice locations: Orchard Lake, MI
O20250313002462 AZ Part B Supplier - Clinic/Group Practice 0840241907 Receives reassigned benefits from 1 practitioner
Practice locations: Scottsdale, AZ
O20250313002520 UT Part B Supplier - Clinic/Group Practice 0840241907 Receives reassigned benefits from 1 practitioner
Practice locations: Draper, UT
O20250313002540 CA Part B Supplier - Clinic/Group Practice 0840241907 Receives reassigned benefits from 1 practitioner
Practice locations: Sacramento, CA
O20250723002427 FL Part B Supplier - Clinic/Group Practice 0840241907 Receives reassigned benefits from 1 practitioner
Practice locations: Pace, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1477544880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 CHERRY VALLEY RD",
            "address_2": "P O BOX 948",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551323",
            "telephone_number": "740-522-3774",
            "fax_number": "740-522-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 CHERRY VALLEY RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551323",
            "telephone_number": "740-522-3774",
            "fax_number": "740-522-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY RADIOLOGISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "740-522-3774",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0139960",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.