Bridgeton Imaging, L.L.C.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

BRIDGETON IMAGING, L.L.C.

Practice address

12121 Saint Charles Rock Rd
Bridgeton, MO 63044-2602

Phone

(314) 291-5050

Fax

(314) 291-8209

NPI assigned

Jan 6, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Michael Kyle Burtnett

Title

SVP of Outpatient Services, Tenet

Phone

(469) 893-2153

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1679877575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 SAINT CHARLES ROCK RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442602",
            "telephone_number": "314-291-5050",
            "fax_number": "314-291-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 SAINT CHARLES ROCK RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442602",
            "telephone_number": "314-291-5050",
            "fax_number": "314-291-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGETON IMAGING, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-06",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "BURTNETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "SVP OF OUTPATIENT SERVICES, TENET",
        "authorized_official_telephone_number": "469-893-2153",
        "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": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Raynae Bray, PHARMD
• Christine E Breakfield, RDN, LD
• Bridgeton Emergency Group LLC
• Bridgeton Foot and Ankle LLC
• Bridgeton Geriatrics LLC
• Bridgeton Operations, LLC
• Bridgeton Pain Group
• Brielle Holly Bright, PT, DPT
• Brighten Your Day Home Health Care LLC.
• Robert Brinkman, M.D.

• Diagnostic Radiology Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.