Organization Active NPI

Omega Nuclear LLC

  • Nuclear Radiology Physician
  • Newark, DE
National Provider Identifier
1508824251
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Radiology PhysicianTaxonomy code 2085N0904X
Legal business name
OMEGA NUCLEAR LLC
Practice address
L12 Omega Drive
Newark, DE 19713-2077
Phone
(302) 368-8150
Fax
(302) 368-3412
NPI assigned
May 3, 2006
Last updated
Dec 21, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
DIA PRACTICE ENTERPRISES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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

Authorized official

Name
Victoria L Peacock, MS, MS
Title
Project Manager
Phone
(302) 993-2330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X NU Primary

Addresses

Primary practice location

L12 Omega Drive
Newark, DE 19713-2077

Mailing address

1601 Milltown Rd
Suite 13
Wilmington, DE 19808-4027
Phone (302) 993-2330

Other identifiers 1

IdentifierTypeStateIssuer
0000142702MedicaidDE

National Provider Directory

National Provider Directory

Locations

12 Omega Dr
Newark, DE 19713
Phone (302) 368-8150

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356048000000",
    "number": "1508824251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MILLTOWN RD",
            "address_2": "SUITE 13",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198084027",
            "telephone_number": "302-993-2330",
            "fax_number": "302-993-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "L12 OMEGA DRIVE",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132077",
            "telephone_number": "302-368-8150",
            "fax_number": "302-368-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA NUCLEAR LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIA PRACTICE ENTERPRISES LLC",
        "enumeration_date": "2006-05-03",
        "last_updated": "2012-12-21",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROJECT MANAGER",
        "authorized_official_telephone_number": "302-993-2330",
        "authorized_official_credential": "MS, MS"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000142702",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; 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.