NPIMap

Organization Active NPI

Northstar Radiology Corporation PA

  • Specialist
  • Plymouth, MN
National Provider Identifier
1487787016
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
27851 Issued in MN
Legal business name
NORTHSTAR RADIOLOGY CORPORATION PA
Practice address
36 Nathan Lane N
Plymouth, MN 55441
Phone
(612) 437-1191
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Authorized official

Name
William J Ford III, MDNPI 1013910702
Title
President
Phone
(612) 437-1191

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 27851 MN Primary

Addresses

Primary practice location

36 Nathan Lane N
Plymouth, MN 55441

Mailing address

PO Box 396
Hopkins, MN 55343-0396
Phone (612) 437-1191

National Provider Directory

National Provider Directory

Locations

36 Nathan Ln N
Plymouth, MN 55441
Phone (763) 588-7099

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1487787016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 396",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553430396",
            "telephone_number": "612-437-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 NATHAN LANE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55441",
            "telephone_number": "612-437-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR RADIOLOGY CORPORATION PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-437-1191",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MN",
            "license": "27851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.