NPIMap

Organization Active NPI

Burlington Radiological Associates

  • Diagnostic Radiology Physician
  • Burlington, NC
National Provider Identifier
1508829029
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BURLINGTON RADIOLOGICAL ASSOCIATES
Practice address
1240 Huffman Mill Rd
Burlington, NC 27215-8700
Phone
(336) 538-7861
Fax
(336) 538-7547
NPI assigned
Apr 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jack G Wall, MDNPI 1902869068
Title
President
Phone
(336) 538-7000

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
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X NC Primary

Addresses

Primary practice location

1240 Huffman Mill Rd
Burlington, NC 27215-8700

Mailing address

PO Box 11546
Knoxville, TN 37939-1546
Phone (865) 766-8800

Other identifiers 2

IdentifierTypeStateIssuer
8901145MedicaidNC
01145OtherNCBCBS OF NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1508829029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11546",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379391546",
            "telephone_number": "865-766-8800",
            "fax_number": "865-766-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 HUFFMAN MILL RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158700",
            "telephone_number": "336-538-7861",
            "fax_number": "336-538-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURLINGTON RADIOLOGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-538-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901145",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "01145",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.