NPIMap

Organization Active NPI

Center for Medical Imaging Inc

  • Diagnostic Radiology Physician
  • Germantown, WI
National Provider Identifier
1679507883
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CENTER FOR MEDICAL IMAGING INC
Practice address
W178N9912 Rivercrest Dr
Suite 102
Germantown, WI 53022-4645
Phone
(262) 255-4500
Fax
(262) 255-6500
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Roger Pellmann, M.D.NPI 1659390557
Title
President
Phone
(262) 255-4500

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X WI

Addresses

Primary practice location

W178N9912 Rivercrest Dr
Suite 102
Germantown, WI 53022-4645

Mailing address

6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 423-4100

Other identifiers 1

IdentifierTypeStateIssuer
21268200MedicaidWI

National Provider Directory

National Provider Directory

Locations

W178N9912 Rivercrest Dr
Ste 102
Germantown, WI 53022
Phone (262) 255-4500

Practitioners & affiliated clinicians

Practitioners 1

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": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679507883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W178N9912 RIVERCREST DR",
            "address_2": "SUITE 102",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530224645",
            "telephone_number": "262-255-4500",
            "fax_number": "262-255-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR MEDICAL IMAGING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PELLMANN",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-255-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21268200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.