Organization Active NPI

Medfund LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • San Antonio, TX
National Provider Identifier
1598768459
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
MEDFUND LLC
Practice address
109 Gallery Cir
Ste 115
San Antonio, TX 78258-3328
Phone
(210) 545-3674
Fax
(210) 545-3691
NPI assigned
May 24, 2005
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
Mr. Martin J Kern
Title
Senior Vice President
Phone
(941) 925-3490

Specialties & licenses 1

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

Addresses

Primary practice location

109 Gallery Cir
Ste 115
San Antonio, TX 78258-3328

Mailing address

240 N Washington Blvd
Sarasota, FL 34236-5945
Phone (941) 925-3490

Other identifiers 4

IdentifierTypeStateIssuer
242745OtherAMERIGROUP
3537014OtherAETNA/MEDSOLUTIONS-HMO
0342DCOtherTXBCBS PROV #
7992617OtherAETNA/MEDSOLUTIONS -PPO

Other names 1

  • Horizon MRI of San Antonio North LLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598768459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N WASHINGTON BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342365945",
            "telephone_number": "941-925-3490",
            "fax_number": "941-953-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 GALLERY CIR",
            "address_2": "STE 115",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583328",
            "telephone_number": "210-545-3674",
            "fax_number": "210-545-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFUND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KERN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "941-925-3490",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "242745",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/MEDSOLUTIONS-HMO",
            "identifier": "3537014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV #",
            "identifier": "0342DC",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/MEDSOLUTIONS -PPO",
            "identifier": "7992617",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizon MRI of San Antonio North LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

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.