Organization Active NPI

Reidsville Imaging Center, LLC

  • Body Imaging Physician
  • Reidsville, NC
National Provider Identifier
1508807249
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
Legal business name
REIDSVILLE IMAGING CENTER, LLC
Practice address
2509 Richardson Dr
Suite a
Reidsville, NC 27320-5901
Phone
(336) 349-5899
Fax
(336) 349-5995
NPI assigned
Jun 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Authorized official

Name
Raymond Eveland
Title
Member
Phone
(336) 202-5593

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085B0100X Primary

Addresses

Primary practice location

2509 Richardson Dr
Suite a
Reidsville, NC 27320-5901

Mailing address

PO Box 16983
Chapel Hill, NC 27516-6983
Phone (919) 967-6646

Other identifiers 2

IdentifierTypeStateIssuer
017YHOtherNCBLUE CROSS/BLUE SHIELD
5904292MedicaidNC

National Provider Directory

National Provider Directory

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": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1508807249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16983",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275166983",
            "telephone_number": "919-967-6646",
            "fax_number": "919-967-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 RICHARDSON DR",
            "address_2": "SUITE A",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205901",
            "telephone_number": "336-349-5899",
            "fax_number": "336-349-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REIDSVILLE IMAGING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "EVELAND",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "336-202-5593"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "017YH",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904292",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.