Bistate Diagnostic

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

0101034219 Issued in VA

Legal business name

BISTATE DIAGNOSTIC

Practice address

RR2 Box 26 Riverbend Est
Bluefield, VA 24605-0784

Phone

(276) 322-4520

Fax

(276) 322-4520

NPI assigned

Sep 25, 2006

Last updated

Sep 12, 2008By 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

Mr. Reynaldo Duiguan Jose, MD

Title

Partner Owner

Phone

(276) 322-4520

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221177600000",
    "number": "1699876706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 784",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "246050784",
            "telephone_number": "276-322-4520",
            "fax_number": "276-322-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR2 BOX 26 RIVERBEND EST",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "246050784",
            "telephone_number": "276-322-4520",
            "fax_number": "276-322-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BISTATE DIAGNOSTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-09-12",
        "status": "A",
        "authorized_official_last_name": "JOSE",
        "authorized_official_first_name": "REYNALDO",
        "authorized_official_middle_name": "DUIGUAN",
        "authorized_official_title_or_position": "PARTNER OWNER",
        "authorized_official_telephone_number": "276-322-4520",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "VA",
            "license": "0101034219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010269989",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan A. Ball, COTA
• Frederick W Barker, MD
• Jessica Beasley
• Erika Elaine Bell, MS,LAT,ATC
• Louisa Roberts Bennitt, LCSW
• Wesley Shane Blankenship, LPTA
• Duane Blevins, PHARMD
• Bluefield College (Bluefield Sports Medicine)
• Bluefield Hospital Company LLC
• Bluefield Hospital Company LLC

• Sonography Radiologic Technologist in Bluefield, VA
• Providers in Bluefield, VA by specialty
• Sonography Radiologic Technologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; 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.