NPIMap

Organization Active NPI

Middle Tennessee Imaging, LLC

Doing business as Premier Radiology Mobile Diagnostics

  • Mobile Radiology Clinic/Center
  • Nashville, TN
National Provider Identifier
1629434394
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
Legal business name
MIDDLE TENNESSEE IMAGING, LLC
Doing business as
Premier Radiology Mobile Diagnostics
Practice address
28 White Bridge Rd
Suite 314
Nashville, TN 37205-1499
Phone
(615) 986-6040
Fax
(615) 986-6041
NPI assigned
Jan 11, 2016
Last updated
Dec 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Authorized official

Name
Naomi M Cassin
Title
Avp, Provider Enrollment
Phone
(312) 724-8477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X Primary

Addresses

Primary practice location

28 White Bridge Rd
Suite 314
Nashville, TN 37205-1499

Mailing address

PO Box 306512
Nashville, TN 37230-6545
Phone (615) 851-6003

Other names 1

  • Premier Radiology Mobile Diagnostics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160513000681 TN Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5698743706 Practice locations: Nashville, TN

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Middle Tennessee Imaging9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1629434394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306512",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306545",
            "telephone_number": "615-851-6003",
            "fax_number": "615-948-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 WHITE BRIDGE RD",
            "address_2": "SUITE 314",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372051499",
            "telephone_number": "615-986-6040",
            "fax_number": "615-986-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE TENNESSEE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "CASSIN",
        "authorized_official_first_name": "NAOMI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AVP, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "312-724-8477"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Radiology Mobile Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Radiology Mobile Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.