NPIMap

Organization Active NPI

Madison County Imaging PC

  • Diagnostic Radiology Physician
  • Anderson, IN
National Provider Identifier
1669488037
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MADISON COUNTY IMAGING PC
Practice address
2015 Jackson Street
Radiology Dept
Anderson, IN 46016-4339
Phone
(765) 649-2511
NPI assigned
Jul 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Eric R Retrum, MDNPI 1073530978
Title
President
Phone
(765) 649-2511

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 Physician 2085R0202X NU Primary

Addresses

Primary practice location

2015 Jackson Street
Radiology Dept
Anderson, IN 46016-4339

Mailing address

2015 Jackson Street
Radiology Dept
Anderson, IN 46016-4339
Phone (765) 649-2511

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669488037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 JACKSON STREET",
            "address_2": "RADIOLOGY DEPT",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164339",
            "telephone_number": "765-649-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 JACKSON STREET",
            "address_2": "RADIOLOGY DEPT",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164339",
            "telephone_number": "765-649-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON COUNTY IMAGING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RETRUM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-649-2511",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

  • 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.