Organization Active NPI

Professional Imaging LLC

  • Radiology Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1619081940
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
PROFESSIONAL IMAGING LLC
Practice address
1050 Old Des Peres Rd Ste 30
Saint Louis, MO 63131-1873
Phone
(314) 743-2000
Fax
(314) 743-2005
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Authorized official

Name
Ms. Nicole L Brooks
Title
Director
Phone
(314) 324-3728

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085B0100X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1050 Old Des Peres Rd Ste 30
Saint Louis, MO 63131-1873

Mailing address

1050 Old Des Peres Rd Ste 30
Saint Louis, MO 63131-1873
Phone (314) 743-2000

Other identifiers 3

IdentifierTypeStateIssuer
198695OtherMOBCBS
7935693OtherAETNA
686591OtherHEALTHLINK

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
26D1084941Professional Imaging1050 Old Des Peres Road, Suite 30, St. Louis, MO 63131Certificate of waiverJun 5, 2028

National Provider Directory

National Provider Directory

Locations

3 E Armour Blvd
Kansas City, MO 64111
Phone (816) 601-4440

777 S New Ballas Rd
Lbby 5
Saint Louis, MO 63141
Phone (314) 238-6901

1050 Old des Peres Rd
Ste 30
Saint Louis, MO 63131
Phone (314) 743-2000

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": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762473600000",
    "number": "1619081940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 OLD DES PERES RD STE 30",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311873",
            "telephone_number": "314-743-2000",
            "fax_number": "314-743-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 OLD DES PERES RD STE 30",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311873",
            "telephone_number": "314-743-2000",
            "fax_number": "314-743-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-324-3728",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "198695",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7935693",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "686591",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.