Organization Active NPI

Professional MRI, LLC

  • Diagnostic Radiology Physician
  • Richmond, KY
National Provider Identifier
1477579084
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PROFESSIONAL MRI, LLC
Practice address
803 Eastern Byp
Richmond, KY 40475-2751
Phone
(859) 623-8823
Fax
(859) 623-8810
NPI assigned
Jul 15, 2006
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
Benjamin Homer McQuaide, M.D.
Title
President
Phone
(859) 623-8823

Specialties & licenses 1

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

Addresses

Primary practice location

803 Eastern Byp
Richmond, KY 40475-2751

Mailing address

PO Box 1429
Frankfort, KY 40602-1429
Phone (502) 226-3858

Other identifiers 2

IdentifierTypeStateIssuer
000000310923OtherKYANTHEM GROUP PIN
65939126MedicaidKY

National Provider Directory

National Provider Directory

Locations

803 Eastern Byp
Richmond, KY 40475
Phone (859) 623-8823

803 Eastern Byp
Richmond, KY 40475
Phone (859) 623-8823

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477579084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1429",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406021429",
            "telephone_number": "502-226-3858",
            "fax_number": "502-223-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 EASTERN BYP",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752751",
            "telephone_number": "859-623-8823",
            "fax_number": "859-623-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCQUAIDE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "HOMER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-623-8823",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP PIN",
            "identifier": "000000310923",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65939126",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.