Organization Active NPI

Rural Diagnostic Radiology, Inc

  • Diagnostic Radiology Physician
  • Centerville, IA
National Provider Identifier
1578664637
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RURAL DIAGNOSTIC RADIOLOGY, INC
Practice address
1 Saint Joseph Dr
Centerville, IA 52544-9017
Phone
(641) 437-4111
NPI assigned
Sep 25, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary A Christensen, M.D.NPI 1689633885
Title
Owner
Phone
(641) 856-5974

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

1 Saint Joseph Dr
Centerville, IA 52544-9017

Mailing address

PO Box 609
Shelton, NE 68876-0609
Phone (308) 647-4900

Other identifiers 1

IdentifierTypeStateIssuer
0310656MedicaidIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578664637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609",
            "city": "SHELTON",
            "state": "NE",
            "postal_code": "688760609",
            "telephone_number": "308-647-4900",
            "fax_number": "308-647-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT JOSEPH DR",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525449017",
            "telephone_number": "641-437-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL DIAGNOSTIC RADIOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "641-856-5974",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0310656",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.