NPIMap

Organization Active NPI

North Brandon Imaging LLC

Doing business as Tower Diagnostic Center of Brandon

  • Diagnostic Radiology Physician
  • Bradon, FL
National Provider Identifier
1639269392
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTH BRANDON IMAGING LLC
Doing business as
Tower Diagnostic Center of Brandon
Practice address
613 Oakfield Drive
Bradon, FL 33511
Phone
(813) 661-2222
Fax
(813) 681-8494
NPI assigned
Oct 13, 2006
Last updated
Aug 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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

Authorized official

Name
Mr. William B. Rutherford
Title
Senior VP
Phone
(615) 309-2190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

613 Oakfield Drive
Bradon, FL 33511

Mailing address

613 Oakfield Dr
Brandon, FL 33511-5714
Phone (813) 661-2222

Other identifiers 3

IdentifierTypeStateIssuer
272079500MedicaidFL
V3028OtherFLBCBS OF FL
P00280433OtherFLRR MEDICARE

Other names 1

  • Tower Diagnostic Center of Brandon Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314662400000",
    "number": "1639269392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115714",
            "telephone_number": "813-661-2222",
            "fax_number": "813-681-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 OAKFIELD DRIVE",
            "city": "BRADON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-661-2222",
            "fax_number": "813-681-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BRANDON IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2011-08-30",
        "status": "A",
        "authorized_official_last_name": "RUTHERFORD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "SENIOR VP",
        "authorized_official_telephone_number": "615-309-2190",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272079500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "V3028",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00280433",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tower Diagnostic Center of Brandon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bradon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.