Organization Active NPI

Northern Oklahoma Diagnostic Imaging LTD

Doing business as Northern Oklahoma Diagnostic Imaging

  • Radiology Clinic/Center
  • Enid, OK
National Provider Identifier
1588648679
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
NORTHERN OKLAHOMA DIAGNOSTIC IMAGING LTD
Doing business as
Northern Oklahoma Diagnostic Imaging
Practice address
1204 W Willow
Suite D
Enid, OK 73703
Phone
(405) 775-4301
Fax
(405) 841-9345
NPI assigned
Dec 1, 2005
Last updated
Apr 1, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Authorized official

Name
Ms. Debra Z Nussbaum
Title
Chief Financial Officer
Phone
(405) 775-4227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1204 W Willow
Suite D
Enid, OK 73703

Mailing address

1204 W Willow
Suite D
Enid, OK 73703
Phone (405) 775-4301

Other identifiers 1

IdentifierTypeStateIssuer
200037450AMedicaidOK

Other names 1

  • Northern Oklahoma Diagnostic Imaging Doing business as

National Provider Directory

National Provider Directory

Locations

1204 W Willow Rd
Ste D
Enid, OK 73703
Phone (580) 242-1115

Practitioners & affiliated clinicians

Practitioners 1

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": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1588648679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 W WILLOW",
            "address_2": "SUITE D",
            "city": "ENID",
            "state": "OK",
            "postal_code": "73703",
            "telephone_number": "405-775-4301",
            "fax_number": "405-841-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 W WILLOW",
            "address_2": "SUITE D",
            "city": "ENID",
            "state": "OK",
            "postal_code": "73703",
            "telephone_number": "405-775-4301",
            "fax_number": "405-841-9345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN OKLAHOMA DIAGNOSTIC IMAGING LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "NUSSBAUM",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "405-775-4227",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200037450A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Oklahoma Diagnostic Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.