NPIMap

Organization Active NPI

Med Tel International Corporation

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Marion, OH
National Provider Identifier
1578697181
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
License
0611IC Issued in OH
Legal business name
MED TEL INTERNATIONAL CORPORATION
Practice address
250 Executive Dr
#C
Marion, OH 43302-6284
Phone
(740) 223-8608
Fax
(740) 223-8308
NPI assigned
Mar 15, 2007
Organization subpart
Yes
Parent organization
MED TEL INTERNATIONAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Authorized official

Name
John Valla
Title
Vice President
Phone
(973) 873-9850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X 0611IC OH Primary

Addresses

Primary practice location

250 Executive Dr
#C
Marion, OH 43302-6284

Mailing address

1430 Spring Hill Rd
Suite 500
McLean, VA 22102-3000
Phone (703) 287-4189

Other identifiers 1

IdentifierTypeStateIssuer
2652071MedicaidOH

Other names 1

  • Wide Open MRI Doing business as

National Provider Directory

National Provider Directory
Part of
Med-Tel Intrntl Corp

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1578697181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 SPRING HILL RD",
            "address_2": "SUITE 500",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221023000",
            "telephone_number": "703-287-4189",
            "fax_number": "703-448-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 EXECUTIVE DR",
            "address_2": "#C",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026284",
            "telephone_number": "740-223-8608",
            "fax_number": "740-223-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED TEL INTERNATIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MED TEL INTERNATIONAL CORPORATION",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "VALLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "973-873-9850"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "OH",
            "license": "0611IC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2652071",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wide Open MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.