Northeast X-Ray

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

License

XT002431 Issued in IN

Legal business name

NORTHEAST X-RAY

Practice address

2928 Parnell Ave
Fort Wayne, IN 46805-2500

Phone

(260) 484-8414

NPI assigned

Jun 27, 2007

Organization subpart

No

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

Authorized official

Name

Christopher M Brown

Title

Owner

Phone

(260) 484-8414

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659578409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2928 PARNELL AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468052500",
            "telephone_number": "260-484-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2928 PARNELL AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468052500",
            "telephone_number": "260-484-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST X-RAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-484-8414"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "IN",
            "license": "XT002431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.