Liberty Portable X-Ray Ohio LLC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

LIBERTY PORTABLE X-RAY OHIO LLC

Practice address

1430 Oak Harbor Rd
Fremont, OH 43420-1025

Phone

(717) 607-1700

Fax

(717) 607-1710

NPI assigned

Jan 8, 2019

Organization subpart

Yes

Parent organization

LIBERTY PORTABLE X-RAY OHIO LLCAs reported in NPPES

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

Authorized official

Name

Danielle Philipps

Title

Director of Operations

Phone

(717) 607-1700

Specialties & licenses 1

Addresses

Part of

Liberty Portable X-Ray Ohio

Locations

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706400000000",
    "number": "1578036943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 BROADWAY",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981733",
            "telephone_number": "717-607-1700",
            "fax_number": "717-607-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 OAK HARBOR RD",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434201025",
            "telephone_number": "717-607-1700",
            "fax_number": "717-607-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY PORTABLE X-RAY OHIO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIBERTY PORTABLE X-RAY OHIO LLC",
        "enumeration_date": "2019-01-08",
        "last_updated": "2024-01-28",
        "certification_date": "2024-01-28",
        "status": "A",
        "authorized_official_last_name": "PHILIPPS",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "717-607-1700"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne J Lewis, LISW
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• Liberty Nursing Center of Fremont, Inc
• Liberty Portable X-Ray Ohio LLC
• Life Enhancement Services of Ohio, LLC
• Brittany Light
• Kaitlyn Light
• Diane Kay Lindenberger, R.PH.
• Renae Michelle Linder, PHARMD, RPH

• Mobile Radiology Clinic/Center in Fremont, OH
• Providers in Fremont, OH by specialty
• Mobile Radiology Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2024; 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.