NPIMap

Organization Active NPI

Concord Imaging Center

  • Radiology Clinic/Center
  • Concord, NH
National Provider Identifier
1700859451
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
CONCORD IMAGING CENTER
Practice address
2 1/2 Beacon St
Concord, NH 03301-4447
Phone
(603) 228-1521
Fax
(603) 225-2510
NPI assigned
Feb 10, 2006
Last updated
Jul 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Authorized official

Name
Timothy J McCormack, MDNPI 1992778773
Title
Director
Phone
(603) 228-1521

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X
Radiology Clinic/Center 261QR0200X Primary
Mammography Clinic/Center 261QR0206X

Addresses

Primary practice location

2 1/2 Beacon St
Concord, NH 03301-4447

Mailing address

2 1/2 Beacon St
Concord, NH 03301-4447
Phone (603) 228-1521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421000655 NH Part B Supplier - Clinic/Group Practice 2466448030 Receives reassigned benefits from 23 practitioners
Practice locations: Concord, NH

National Provider Directory

National Provider Directory

Locations

248 Pleasant St
Ste 102
Concord, NH 03301

248 Pleasant St
Ste 106
Concord, NH 03301

60 Commercial St
Ste 101
Concord, NH 03301

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596153600000",
    "number": "1700859451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 1/2 BEACON ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033014447",
            "telephone_number": "603-228-1521",
            "fax_number": "603-225-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 1/2 BEACON ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033014447",
            "telephone_number": "603-228-1521",
            "fax_number": "603-225-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORD IMAGING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "MCCORMACK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "603-228-1521",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.