NPIMap

Organization Active NPI

Independent Imaging, LLC

  • Radiology Clinic/Center
  • Lake Worth, FL
National Provider Identifier
1629406293
Registry record updated Oct 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
HCC9378 Issued in FL
Legal business name
INDEPENDENT IMAGING, LLC
Practice address
5051 S Congress Ave
Lake Worth, FL 33461-4704
Phone
(561) 795-5558
Fax
(561) 792-7300
NPI assigned
Oct 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2013

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

Authorized official

Name
Arthur Hansen
Title
Owner
Phone
(561) 204-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X HCC9378 FL Primary

Addresses

Primary practice location

5051 S Congress Ave
Lake Worth, FL 33461-4704

Mailing address

PO Box 1313
Loxahatchee, FL 33470-1313
Phone (561) 766-1301

Other identifiers 1

IdentifierTypeStateIssuer
V007NOtherFLBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050817000898 FL Part B Supplier - Clinic/Group Practice 4587694716 Receives reassigned benefits from 40 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Belle Glade, FL; Wellington, FL; Lake Worth, FL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Independent Imaging LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1381968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381968000000",
    "number": "1629406293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1313",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334701313",
            "telephone_number": "561-766-1301",
            "fax_number": "561-318-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5051 S CONGRESS AVE",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334614704",
            "telephone_number": "561-795-5558",
            "fax_number": "561-792-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-17",
        "last_updated": "2013-10-17",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-204-4800"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "FL",
            "license": "HCC9378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "V007N",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; 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.