NPIMap

Organization Active NPI

Proscan Imaging of Pickerington, LLC

  • Diagnostic Radiology Physician
  • Pickerington, OH
National Provider Identifier
1629036223
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1206IC Issued in OH
Legal business name
PROSCAN IMAGING OF PICKERINGTON, LLC
Practice address
1797 Hill Rd N Ste 102
Pickerington, OH 43147-7996
Phone
(614) 920-6364
NPI assigned
May 3, 2006
Last updated
Nov 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Authorized official

Name
Karen Amaya
Title
Coo
Phone
(513) 924-5174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 1206IC OH Primary

Addresses

Primary practice location

1797 Hill Rd N Ste 102
Pickerington, OH 43147-7996

Mailing address

417 Hill Rd N
Pickerington, OH 43147-1310
Phone (614) 920-6364

Other identifiers 1

IdentifierTypeStateIssuer
000000389018OtherANTHEM PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060818000103 OH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8921001694 Practice locations: Pickerington, OH

National Provider Directory

National Provider Directory

Locations

1797 Hill Rd N
Ste 102
Pickerington, OH 43147
Phone (614) 920-6364

475 Hill Rd N
Pickerington, OH 43147
Phone (614) 834-1500

Practitioners & affiliated clinicians

Practitioners 48

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.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572825600000",
    "number": "1629036223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 HILL RD N",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431471310",
            "telephone_number": "614-920-6364",
            "fax_number": "614-920-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1797 HILL RD N STE 102",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431477996",
            "telephone_number": "614-920-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSCAN IMAGING OF PICKERINGTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2019-11-04",
        "status": "A",
        "authorized_official_last_name": "AMAYA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "513-924-5174"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "1206IC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000389018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pickerington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.