Organization Active NPI

Indiana MRI of Evansville, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Evansville, IN
National Provider Identifier
1720178726
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
INDIANA MRI OF EVANSVILLE, LLC
Practice address
729 John St
Evansville, IN 47713-2754
Phone
(812) 428-3440
Fax
(812) 463-5238
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Owen Lauer
Title
Managing Member
Phone
(812) 336-0056

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary
Radiology Clinic/Center 261QR0200X

Addresses

Primary practice location

729 John St
Evansville, IN 47713-2754

Mailing address

3900 S Walnut St
Bloomington, IN 47401-7393
Phone (812) 336-0056

Other identifiers 2

IdentifierTypeStateIssuer
000000221914OtherINANTHEM
200077780AMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1720178726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 S WALNUT ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474017393",
            "telephone_number": "812-336-0056",
            "fax_number": "812-336-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 JOHN ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477132754",
            "telephone_number": "812-428-3440",
            "fax_number": "812-463-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA MRI OF EVANSVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "LAUER",
        "authorized_official_first_name": "OWEN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "812-336-0056"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000221914",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200077780A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.