NPIMap

Organization Active NPI

Southside Radiology Associates, Inc

  • Diagnostic Radiology Physician
  • Cleveland, OH
National Provider Identifier
1669474276
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SOUTHSIDE RADIOLOGY ASSOCIATES, INC
Practice address
4110 Warrensville Ctr Rd
Cleveland, OH 44122-7051
Phone
(216) 491-7014
Fax
(216) 491-7575
NPI assigned
Aug 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Authorized official

Name
Dr. Jeffrey UngerNPI 1427050962
Title
President
Phone
(216) 491-7014

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

4110 Warrensville Ctr Rd
Cleveland, OH 44122-7051

Mailing address

4110 Warrensville Ctr Rd
Cleveland, OH 44122-7051
Phone (216) 491-7014

Other identifiers 1

IdentifierTypeStateIssuer
0130941MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1669474276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 WARRENSVILLE CTR RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441227051",
            "telephone_number": "216-491-7014",
            "fax_number": "216-491-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 WARRENSVILLE CTR RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441227051",
            "telephone_number": "216-491-7014",
            "fax_number": "216-491-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE RADIOLOGY ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "UNGER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-491-7014",
        "authorized_official_name_prefix": "Dr."
    },
    "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": "0130941",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; 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.