NPIMap

Organization Active NPI

Titan MRI LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Lake City, FL
National Provider Identifier
1548864333
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
TITAN MRI LLC
Practice address
289 SW Stonegate Ter Ste 102
Lake City, FL 32024-3457
Phone
(386) 245-6644
NPI assigned
Nov 23, 2020
Last updated
Nov 23, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
TITAN MRI LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

Name
Joe Bolton
Title
Member/Owner
Phone
(352) 672-2246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary

Addresses

Primary practice location

289 SW Stonegate Ter Ste 102
Lake City, FL 32024-3457

Mailing address

2605 NW 75TH St
Gainesville, FL 32606-6314
Phone (352) 672-2246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210928001179 FL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3678811312 Practice locations: Lake City, FL

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Titan MRI LLC2 organizations share this tax ID, including this one
Part of
Titan MRI LLC

Other organizations with this tax ID 1

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

Locations

919 NW 57th St
Ste 20
Gainesville, FL 32605
Phone (352) 672-6644

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1548864333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 NW 75TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066314",
            "telephone_number": "352-672-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 SW STONEGATE TER STE 102",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320243457",
            "telephone_number": "386-245-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITAN MRI LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TITAN MRI LLC",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "352-672-2246"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.