NPIMap

Organization Active NPI

Diagnostic Imaging of in PC

  • Diagnostic Radiology Physician
  • Warsaw, IN
National Provider Identifier
1619951233
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01034289A Issued in IN
Legal business name
DIAGNOSTIC IMAGING OF IN PC
Practice address
2101 Dubois Dr
Warsaw, IN 46580-3210
Phone
(574) 267-3200
Fax
(314) 821-1833
NPI assigned
Dec 6, 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
Steven L Hossler, M.D.NPI 1124002746
Title
Director of Radiology
Phone
(574) 267-3200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 01034289A IN Primary

Addresses

Primary practice location

2101 Dubois Dr
Warsaw, IN 46580-3210

Mailing address

PO Box 11086
Fort Wayne, IN 46855-1086
Phone (314) 821-8055

Other identifiers 5

IdentifierTypeStateIssuer
CB0039OtherTRAVELERS
000000012713OtherENCORE
1414OtherPHP
0682426MedicaidOH
000000084887OtherINBCBS

National Provider Directory

National Provider Directory

Locations

7325 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (219) 432-0135

Practitioners & affiliated clinicians

Practitioners 5

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": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619951233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11086",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468551086",
            "telephone_number": "314-821-8055",
            "fax_number": "314-821-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 DUBOIS DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803210",
            "telephone_number": "574-267-3200",
            "fax_number": "314-821-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC IMAGING OF IN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOSSLER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF RADIOLOGY",
        "authorized_official_telephone_number": "574-267-3200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01034289A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS",
            "identifier": "CB0039",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENCORE",
            "identifier": "000000012713",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "1414",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0682426",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000084887",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

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.