NPIMap

Organization Active NPI

Community Imaging Associates, LLC

  • Physiological Laboratory
  • Fishers, IN
National Provider Identifier
1588032023
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
COMMUNITY IMAGING ASSOCIATES, LLC
Practice address
13121 Olio Rd Ste 120
Fishers, IN 46037-7240
Phone
(317) 621-0375
Fax
(317) 621-3070
NPI assigned
Sep 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Authorized official

Name
Jon Fohrer
Title
President
Phone
(317) 621-7432

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

13121 Olio Rd Ste 120
Fishers, IN 46037-7240

Mailing address

7340 Shadeland Sta
Suite 200
Indianapolis, IN 46256-3979
Phone (317) 621-0375

Other names 1

  • Community Breast Screening-Saxony Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160321000271 IN Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2062719958 Practice locations: Fishers, IN
O20160321001774 IN Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2062719958 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Indianapolis, IN

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0967111Community Physicians of in OBGYN Care Saxony13121 Olio Road, Suite 220, Fishers, IN 46037Certificate of waiverDec 31, 2027
15D2044359Community Phy of Ind Inc/Pediatric13121 Olio Road, Ste 260, Fishers, IN 46037Certificate of waiverMar 22, 2027
15D2167142Community Imaging Associates13121 Olio Road, Suite 120, Fishers, IN 46037Certificate of waiverJun 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Community Breast Screening-Carmel3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

11911 N Meridian St
Ste 175
Carmel, IN 46032
Phone (317) 621-6730

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564444800000",
    "number": "1588032023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7340 SHADELAND STA",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563979",
            "telephone_number": "317-621-0375",
            "fax_number": "317-621-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13121 OLIO RD STE 120",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460377240",
            "telephone_number": "317-621-0375",
            "fax_number": "317-621-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY IMAGING ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2019-07-30",
        "status": "A",
        "authorized_official_last_name": "FOHRER",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-621-7432"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Breast Screening-Saxony",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Breast Screening-Saxony",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.