Organization Active NPI

Radiological Services, Inc

  • Diagnostic Radiology Physician
  • Bartlesville, OK
National Provider Identifier
1659311470
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGICAL SERVICES, INC
Practice address
3500 E Frank Phillips Blvd
Bartlesville, OK 74006-2411
Phone
(918) 333-7200
NPI assigned
Jun 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Authorized official

Name
Michael Reburn, MD
Title
President
Phone
(918) 664-9892

Specialties & licenses 1

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

Addresses

Primary practice location

3500 E Frank Phillips Blvd
Bartlesville, OK 74006-2411

Mailing address

PO Box 1748
Lowell, AR 72745-1748
Phone (855) 896-8451

Other identifiers 2

IdentifierTypeStateIssuer
100729150AMedicaidOK
100212370AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050311000120 OK Part B Supplier - Clinic/Group Practice 9739130139 Receives reassigned benefits from 2 practitioners
Practice locations: Bartlesville, OK; Vinita, OK
O20050411001312 KS Part B Supplier - Clinic/Group Practice 9739130139 Practice locations: Coffeyville, KS; Sedan, KS; Neodesha, KS

National Provider Directory

National Provider Directory

Locations

601 S High St
Caney, KS 67333
Phone (620) 879-2182

412 E 5th St
Bartlesville, OK 74003
Phone (918) 336-7211

457 Laurence Dr
Ste 444
Heath, TX 75032

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": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541980800000",
    "number": "1659311470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1748",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727451748",
            "telephone_number": "855-896-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 E FRANK PHILLIPS BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062411",
            "telephone_number": "918-333-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGICAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2018-11-12",
        "status": "A",
        "authorized_official_last_name": "REBURN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-664-9892",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100729150A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100212370A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; 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.