Jackson Village Imaging, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

JACKSON VILLAGE IMAGING, LLC

Doing business as

Meridian Imaging

Practice address

27 S Cooks Bridge Rd
Jackson, NJ 08527-2524

Phone

(732) 671-6618

NPI assigned

Dec 30, 2014

Last updated

Dec 30, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William Perry Baker

Title

Secretary/Cfo

Phone

(615) 550-6049

Specialties & licenses 1

Addresses

Other names 1

• Meridian Imaging Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1699163527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 CRESCENT CENTRE DR",
            "address_2": "SUITE 200",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370674626",
            "telephone_number": "615-550-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 S COOKS BRIDGE RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272524",
            "telephone_number": "732-671-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON VILLAGE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-30",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PERRY",
        "authorized_official_title_or_position": "SECRETARY/CFO",
        "authorized_official_telephone_number": "615-550-6049"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jackson Village Pharmacy LLC (Hackensack Meridian Village Pharmacy)
• Jackson Village Pharmacy LLC (Hackensack Meridian Village Pharmacy)
• Shavon Nicole Jackson, BCBA

• Diagnostic Radiology Physician in Jackson, NJ
• Providers in Jackson, NJ by specialty
• Diagnostic Radiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.