Midway Ultrasound Diagnostic Services

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

42861 Issued in MD

Legal business name

MIDWAY ULTRASOUND DIAGNOSTIC SERVICES

Practice address

1801 SE Hillmoor Dr
Port St Lucie, FL 34952-7553

Phone

(678) 994-5407

NPI assigned

Jul 31, 2016

Organization subpart

No

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

Authorized official

Name

Edward Francis Crooks, RDMS, RVT, RDCS

Title

Ownet

Phone

(678) 994-5407

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1469923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469923200000",
    "number": "1689127201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527553",
            "telephone_number": "678-994-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527553",
            "telephone_number": "678-994-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWAY ULTRASOUND DIAGNOSTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-31",
        "last_updated": "2016-07-31",
        "status": "A",
        "authorized_official_last_name": "CROOKS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "OWNET",
        "authorized_official_telephone_number": "678-994-5407",
        "authorized_official_credential": "RDMS, RVT, RDCS"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "MD",
            "license": "42861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Radiology Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.