Wentzville Imaging Center, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

WENTZVILLE IMAGING CENTER, LLC

Practice address

972 Wentzville Parkway
Wentzville, MO 63385

Phone

(636) 327-8888

Fax

(636) 327-5522

NPI assigned

Jul 14, 2021

Organization subpart

No

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

Authorized official

Name

Dr. David King, MD

Title

Owner

Phone

(314) 991-4674

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Harry Gus Greditzer IV, M.D.

  • Diagnostic Radiology Physician
  • Saint Louis, MO
  • NPI 1174753982
  NPD

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683244800000",
    "number": "1700458296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 WENTZVILLE PARKWAY",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "63385",
            "telephone_number": "636-327-8888",
            "fax_number": "636-327-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "972 WENTZVILLE PARKWAY",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "63385",
            "telephone_number": "636-327-8888",
            "fax_number": "636-327-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENTZVILLE IMAGING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-991-4674",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CARETRACKER",
            "affiliation": "Y",
            "affiliationName": "Joint Health LLC",
            "address_1": "633 Emerson Rd",
            "address_2": "Suite 10",
            "city": "Creve Coeur",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather Welch, MSW, LCSW
• John C Wendt, MD
• Lisa Dianne Wenger, LPC
• Wentzville Adult Day Center LLC
• Wentzville Family Dentistry
• Wentzville Orthodontics
• Wentzville Pediatric Dentistry, LLC
• Wentzville R-IV School District
• Wentzville School District
• Wentzville Surgery Center LLC

• Radiology Clinic/Center in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Radiology Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.