Carolina Imaging LLC of Fayetteville

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

CAROLINA IMAGING LLC OF FAYETTEVILLE

Practice address

3628 Cape Center Dr
Fayetteville, NC 28304-4406

Phone

(910) 483-1321

Fax

(910) 323-3521

NPI assigned

May 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Geoffrey K. Gardner

Title

SVP Finance and Revenue Cycle

Phone

(336) 718-2078

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Tax ID family

Carolina Imaging LLC of Fayetteville2 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.

• Carolina Imaging LLC of Fayetteville

  • Diagnostic Radiology Physician
  • Fayetteville, NC
  • NPI 1205000916
  NPD tax ID

Member of 1

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

• Foundation Health Systems LLC

  • Physical Therapy Clinic/Center
  • Winston Salem, NC
  • NPI 1205894029

  Member Of

  NPD member

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel S Gordon, MD

  • Diagnostic Radiology Physician
  • Fayetteville, NC
  • NPI 1275589012
  NPD
• Scott T McGraw, MD

  • Diagnostic Radiology Physician
  • Laurinburg, NC
  • NPI 1821097536
  NPD

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1669430971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933393",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311930001",
            "telephone_number": "866-659-1211",
            "fax_number": "336-774-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 CAPE CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044406",
            "telephone_number": "910-483-1321",
            "fax_number": "910-323-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA IMAGING LLC OF FAYETTEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "SVP FINANCE AND REVENUE CYCLE",
        "authorized_official_telephone_number": "336-718-2078",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "890108T",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "153417000",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00450149",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "0108T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Health Care Center of Cumberland County, LP
• Carolina Heart Physicians PLLC
• Carolina Homehealth Agency LLC
• Carolina Hope Behavioral Health LLC
• Carolina Imaging LLC of Fayetteville
• Carolina Imaging LLC of Fayetteville
• Carolina Kidney Care, PA
• Carolina Medical Specialties, Inc.
• Carolina Medical Supplies, Inc.
• Carolina Neurology Associates, PLLC

• Diagnostic Radiology Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.