NPIMap

Organization Active NPI

Southern Tennessee Radiology

  • Radiology Clinic/Center
  • Winchester, TN
National Provider Identifier
1487680732
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
SOUTHERN TENNESSEE RADIOLOGY
Practice address
185 Hospital Rd
Winchester, TN 37398
Phone
(866) 457-9896
Fax
(706) 226-2283
NPI assigned
Jun 25, 2006
Last updated
Oct 23, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Authorized official

Name
Paul D Ellis, MDNPI 1528025673
Title
Owner
Phone
(866) 457-9896

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
Radiology Clinic/Center 261QR0200X NU Primary

Addresses

Primary practice location

185 Hospital Rd
Winchester, TN 37398

Mailing address

PO Box 2125
Dalton, GA 30720
Phone (866) 457-9896

Other identifiers 2

IdentifierTypeStateIssuer
DE2147OtherTNRAILROAD MEDICARE
3732584MedicaidTN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1487680732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2125",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "866-457-9896",
            "fax_number": "706-226-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 HOSPITAL RD",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "37398",
            "telephone_number": "866-457-9896",
            "fax_number": "706-226-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TENNESSEE RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-457-9896",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE2147",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3732584",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.