Cape Radiology Group I LLC

Key facts

NPI

1598708331

Entity type

Organization (NPI type 2)

Primary specialty

Diagnostic Radiology Physician 2085R0202X

Legal business name

CAPE RADIOLOGY GROUP I LLC

Practice address

70 Doctors Park
Cape Girardeau, MO 63703-4928

Phone

(573) 334-6071

Fax

(573) 334-4739

NPI assigned

Jun 13, 2006

Organization subpart

No

Authorized official

Name

Dr. Mark L. Gates, MD

Title

President

Phone

(573) 334-6071

Member of 1

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

• Orthopaedic Associates of Southeast Missouri, P.C. Orthopaedic Surgery Physician · Cape Girardeau, MO · NPI 1902989072
  NPD member Member Of

Practitioners 2

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

• Todd M. Buersmeyer, MD Diagnostic Radiology Physician · Cape Girardeau, MO · NPI 1487858676
  NPD DIAGNOSTIC RADIOLOGY
• Michael Evan Thomas, M.D. Diagnostic Radiology Physician · Cape Girardeau, MO · NPI 1154501393
  NPD (past) DIAGNOSTIC RADIOLOGY

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MO

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• CRG LLC Other name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 20, 2022.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1598708331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "573-334-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "573-334-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPE RADIOLOGY GROUP I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-334-6071",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRG LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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All providers in Cape Girardeau, MO · Diagnostic Radiology Physician in Missouri