NPIMap

Organization Active NPI

Greater Lafayette Health Services

Doing business as Innervision Advanced Medical Imaging

  • Radiology Clinic/Center
  • Lafayette, IN
National Provider Identifier
1710065750
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
GREATER LAFAYETTE HEALTH SERVICES
Doing business as
Innervision Advanced Medical Imaging
Practice address
1411 S Creasy LN
Suite 130
Lafayette, IN 47905-7438
Phone
(765) 447-7447
NPI assigned
Nov 1, 2006
Last updated
Nov 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Authorized official

Name
Mr. Terrance E Wilson
Title
Chief Executive Officer
Phone
(765) 423-6161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X IN Primary

Addresses

Primary practice location

1411 S Creasy LN
Suite 130
Lafayette, IN 47905-7438

Mailing address

2400 South St
Lafayette, IN 47904-3027

Other identifiers 1

IdentifierTypeStateIssuer
000000311919OtherANTHEM

Other names 1

  • Innervision Advanced Medical Imaging Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Franciscan Health Lafayette24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1710065750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 SOUTH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 S CREASY LN",
            "address_2": "SUITE 130",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479057438",
            "telephone_number": "765-447-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER LAFAYETTE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "765-423-6161",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000311919",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innervision Advanced Medical Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.