Elite Imaging of North County, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

ELITE IMAGING OF NORTH COUNTY, LLC

Practice address

433 Lynn Haven LN
Hazelwood, MO 63042-1808

Phone

(314) 731-0600

Fax

(314) 731-0601

NPI assigned

Nov 11, 2008

Organization subpart

No

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

Authorized official

Name

Cecil S. Gray

Title

Member

Phone

(913) 669-6161

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229385600000",
    "number": "1720232192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 LYNN HAVEN LN",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421808",
            "telephone_number": "314-731-0600",
            "fax_number": "314-731-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 LYNN HAVEN LN",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421808",
            "telephone_number": "314-731-0600",
            "fax_number": "314-731-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE IMAGING OF NORTH COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-12-16",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "CECIL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "913-669-6161"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in Hazelwood, MO
• Providers in Hazelwood, 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 Dec 16, 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.