NPIMap

Organization Active NPI

Alpha One Imaging, LLC

  • Physiological Laboratory
  • Baton Rouge, LA
National Provider Identifier
1528313111
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
License
6566327 Issued in LA
Legal business name
ALPHA ONE IMAGING, LLC
Practice address
16511 Highland Club Ave
Baton Rouge, LA 70817-7020
Phone
(225) 590-0790
Fax
(225) 709-9444
NPI assigned
Jul 19, 2012
Last updated
Oct 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Authorized official

Name
Howard Nicholas Kidd
Title
Ceo
Phone
(225) 590-0790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X 6566327 LA Primary

Addresses

Primary practice location

16511 Highland Club Ave
Baton Rouge, LA 70817-7020

Mailing address

16511 Highland Club Ave
Baton Rouge, LA 70817-7020
Phone (225) 590-0790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121203000513 LA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1658448576 Practice locations: Baton Rouge, LA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Alpha One Imaging, LLC

    dba Alpha One Imaging

    • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
    • Baton Rouge, LA
    • NPI 1508027582

    1658448576

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
Alpha One Imaging2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

11930 Perkins Rd
Ste B
Baton Rouge, LA 70810
Phone (225) 590-0790

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349827200000",
    "number": "1528313111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16511 HIGHLAND CLUB AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708177020",
            "telephone_number": "225-590-0790",
            "fax_number": "225-709-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16511 HIGHLAND CLUB AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708177020",
            "telephone_number": "225-590-0790",
            "fax_number": "225-709-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA ONE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-10-10",
        "status": "A",
        "authorized_official_last_name": "KIDD",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-590-0790"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "LA",
            "license": "6566327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.