NPIMap

Organization Active NPI

Easley M R I L L C

  • Diagnostic Radiology Physician
  • Easley, SC
National Provider Identifier
1508836974
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
EASLEY M R I L L C
Practice address
200 Fleetwood Dr
Suite 100
Easley, SC 29640-2022
Phone
(864) 552-7470
Fax
(864) 552-7471
NPI assigned
Jan 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Authorized official

Name
Dr. Charles David Williams III, M DNPI 1457323016
Title
President
Phone
(864) 295-4410

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 Primary

Addresses

Primary practice location

200 Fleetwood Dr
Suite 100
Easley, SC 29640-2022

Mailing address

PO Box 3088
Greenville, SC 29602-3088
Phone (864) 552-7470

Other identifiers 2

IdentifierTypeStateIssuer
SL0051MedicaidSC
CJ7945OtherSCRAILROAD MEDICARE

Other names 1

  • Easley MRI Other name

National Provider Directory

National Provider Directory

Locations

200 Fleetwood Dr
Ste 100
Easley, SC 29640
Phone (864) 442-7618

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1508836974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3088",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296023088",
            "telephone_number": "864-552-7470",
            "fax_number": "864-552-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FLEETWOOD DR",
            "address_2": "SUITE 100",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296402022",
            "telephone_number": "864-552-7470",
            "fax_number": "864-552-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASLEY M R I L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-295-4410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SL0051",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ7945",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Easley MRI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Easley, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.