NPIMap

Organization Active NPI

Alpha One Imaging, LLC

Doing business as Alpha One Imaging

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Baton Rouge, LA
National Provider Identifier
1508027582
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
License
9582 Issued in LA
Legal business name
ALPHA ONE IMAGING, LLC
Doing business as
Alpha One Imaging
Practice address
16511 Highland Club Ave
Baton Rouge, LA 70817-7020
Phone
(225) 235-0322
NPI assigned
Jun 23, 2008
Last updated
Sep 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Authorized official

Name
Randel Worthy
Title
Administrator
Phone
(225) 590-0790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X 9582 LA Primary

Addresses

Primary practice location

16511 Highland Club Ave
Baton Rouge, LA 70817-7020

Mailing address

8595 United Plaza Blvd
Baton Rouge, LA 70809-2251
Phone (225) 590-0790

Other names 1

  • Alpha One Imaging Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080918000410 LA Part B Supplier - Portable X-Ray Supplier 1658448576 Receives reassigned benefits from 1 practitioner
Practice locations: Baton Rouge, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508027582. Details of each certification follow.

Portable X-ray supplier certification: CCN 19X0009836

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ALPHA ONE IMAGING, LLC
Certification status
Active
Provider type (POS)
Portable X-ray supplier
Participating since
May 26, 2009
Last certification
Dec 12, 2019
Ownership / control type
Partnership
Facility address
16511 Highland Club Avenue
Baton Rouge, LA 70817

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Alpha One Imaging2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 11

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": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1508027582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8595 UNITED PLAZA BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708092251",
            "telephone_number": "225-590-0790",
            "fax_number": "225-709-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16511 HIGHLAND CLUB AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708177020",
            "telephone_number": "225-235-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA ONE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "WORTHY",
        "authorized_official_first_name": "RANDEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "225-590-0790"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "LA",
            "license": "9582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpha One Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.