NPIMap

Organization Active NPI

Gainesville Radiology Group West, LLC

  • Diagnostic Radiology Physician
  • Gainesville, FL
National Provider Identifier
1508869405
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
256176 Issued in FL
Legal business name
GAINESVILLE RADIOLOGY GROUP WEST, LLC
Practice address
4960 W Newberry Rd
Ste 280
Gainesville, FL 32607-2201
Phone
(352) 371-3336
Fax
(352) 371-3372
NPI assigned
May 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tony Arvesu
Title
Managing Member
Phone
(352) 332-2040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 256176 FL Primary

Addresses

Primary practice location

4960 W Newberry Rd
Ste 280
Gainesville, FL 32607-2201

Mailing address

4960 W Newberry Rd
Ste 280
Gainesville, FL 32607-2201
Phone (352) 371-3336

Other identifiers 2

IdentifierTypeStateIssuer
V3013OtherFLBCBS IDTF NUMBER EAST OFC
V2766OtherFLBCBS IDTF NUMBER

Other names 1

  • Putnam Radiology Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Doctors Imaging Group LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

4960 Newberry Rd
Ste 280
Gainesville, FL 32607
Phone (352) 371-3336

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508869405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 W NEWBERRY RD",
            "address_2": "STE 280",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072201",
            "telephone_number": "352-371-3336",
            "fax_number": "352-371-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 W NEWBERRY RD",
            "address_2": "STE 280",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072201",
            "telephone_number": "352-371-3336",
            "fax_number": "352-371-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAINESVILLE RADIOLOGY GROUP WEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ARVESU",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "352-332-2040"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "256176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IDTF NUMBER EAST OFC",
            "identifier": "V3013",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IDTF NUMBER",
            "identifier": "V2766",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Putnam Radiology Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.