Radiology Group LLC

Primary specialty

Health EducatorTaxonomy code 174H00000X

License

1043253602 Issued in MI

Legal business name

RADIOLOGY GROUP LLC

Practice address

27789 Mound Rd Ste 100
Warren, MI 48092-2697

Phone

(313) 209-3353

Fax

(313) 406-7255

NPI assigned

Aug 23, 2016

Organization subpart

No

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

Authorized official

Name

Sam Hackette, MD

Title

Manager

Phone

(727) 422-4680

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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

• Sam Hakki Hackette, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Warren, MI
  • NPI 1043253602
  Medicare reassignment NPD

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1528513199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42383 GARFIELD RD UNIT 380560",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480387718",
            "telephone_number": "727-422-4680",
            "fax_number": "313-406-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27789 MOUND RD STE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922697",
            "telephone_number": "313-209-3353",
            "fax_number": "313-406-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-23",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "HACKETTE",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "727-422-4680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": "MI",
            "license": "1043253602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Noelle Raad
• Soodad Rabban, FNP
• Jacqueline Ann Rabine
• Emily Radcliff-Painter
• Tiffany Radcliff
• Radiology Specialties PC
• Ranyah Rafiq
• Peggy Rahal, MD
• Rahman Dental Associates PC
• Mohammed Rahman

• Health Educator in Warren, MI
• Providers in Warren, MI by specialty
• Health Educator in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.