Organization Active NPI

Dothan Diagnostic Imaging Radiology, PLLC

Doing business as Dothan Diagnostic Imaging

  • Diagnostic Radiology Physician
  • Dothan, AL
National Provider Identifier
1528445145
Registry record updated Jan 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DOTHAN DIAGNOSTIC IMAGING RADIOLOGY, PLLC
Doing business as
Dothan Diagnostic Imaging
Practice address
217 Graceland Dr Ste 4
Dothan, AL 36305-7376
Phone
(334) 792-1525
NPI assigned
May 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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

Authorized official

Name
Dr. Ross W. Barnett, MDNPI 1205808755
Title
Owner
Phone
(334) 792-1525

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

217 Graceland Dr Ste 4
Dothan, AL 36305-7376

Mailing address

217 Graceland Dr Ste 4
Dothan, AL 36305-7376
Phone (334) 792-1525

Other names 1

  • Dothan Diagnostic Imaging Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150721002364 AL Part B Supplier - Clinic/Group Practice 7618280595 Receives reassigned benefits from 1 practitioner
Practice locations: Dothan, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D1016395Dothan Diagnostic Imaging Inc217 Graceland Drive Ste 4, Dothan, AL 36305Certificate of waiverNov 6, 2026

National Provider Directory

National Provider Directory

Locations

217 Graceland Dr
Ste 4
Dothan, AL 36305
Phone (334) 792-1525

Practitioners & affiliated clinicians

Practitioners 1

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": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548374400000",
    "number": "1528445145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 GRACELAND DR STE 4",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363057376",
            "telephone_number": "334-792-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 GRACELAND DR STE 4",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363057376",
            "telephone_number": "334-792-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOTHAN DIAGNOSTIC IMAGING RADIOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2019-01-25",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-792-1525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dothan Diagnostic Imaging",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dothan Diagnostic Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.