Organization Active NPI

Premier Imaging Group, P.a.

  • Radiology Clinic/Center
  • Charlotte, NC
National Provider Identifier
1730073149
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
PREMIER IMAGING GROUP, P.A.
Practice address
1300 South Blvd Ste 30018
Charlotte, NC 28203-4280
Phone
(843) 212-9397
NPI assigned
Jun 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Jeffrey Waronker
Title
Managing Director
Phone
(617) 586-2299

Specialties & licenses 1

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

Addresses

Primary practice location

1300 South Blvd Ste 30018
Charlotte, NC 28203-4280

Mailing address

1300 South Blvd Ste 30018
Charlotte, NC 28203-4280

National Provider Directory

National Provider Directory

Locations

1300 South Blvd
Ste 30018
Charlotte, NC 28203
Phone (843) 212-9397

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1730073149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SOUTH BLVD STE 30018",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SOUTH BLVD STE 30018",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034280",
            "telephone_number": "843-212-9397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER IMAGING GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "WARONKER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "617-586-2299"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.