Premier Diagnostic Imaging, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD6278 Issued in TN

Legal business name

PREMIER DIAGNOSTIC IMAGING, LLC

Practice address

315 N Washington Ave
Suite 103
Cookeville, TN 38501-2603

Phone

(931) 528-1800

Fax

(931) 528-2443

NPI assigned

May 16, 2006

Last updated

Sep 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William M Humphrey, MDNPI 1043244684

Title

Provider/President

Phone

(931) 528-2443

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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.

• Seth Winston Means, M.D.

  • Diagnostic Radiology Physician
  • Cookeville, TN
  • NPI 1922271873
  Medicare reassignment Care Compare group NPD
• Randall Bruce Clark II, D.O.

  • Diagnostic Radiology Physician
  • Cape Girardeau, MO
  • NPI 1265873111

  TN

  Medicare reassignment Care Compare group NPD
• Anderson Webb, MD

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1285139550

  TN

  Medicare reassignment Care Compare group NPD
• William Merritt Humphrey, MD

  • Diagnostic Radiology Physician
  • Cookeville, TN
  • NPI 1043244684
  Authorized official Same address or phone
• Daniel Francis Coonce, MD

  • Radiological Physics Physician
  • Cookeville, TN
  • NPI 1598798902
  NPD
• Gregg Delgado, D.O.

  • Diagnostic Radiology Physician
  • Sheffield, AL
  • NPI 1629059175
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1730130345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1502",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385031502",
            "telephone_number": "931-528-1800",
            "fax_number": "931-528-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N WASHINGTON AVE",
            "address_2": "SUITE 103",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012603",
            "telephone_number": "931-528-1800",
            "fax_number": "931-528-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DIAGNOSTIC IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "HUMPHREY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER/PRESIDENT",
        "authorized_official_telephone_number": "931-528-2443",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD6278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3037577",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN BCBS",
            "identifier": "3134538",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN BCBS",
            "identifier": "3156107",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3035368",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN BCBS",
            "identifier": "3134540",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN BCBS",
            "identifier": "3134541",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN BCBS",
            "identifier": "3134539",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3193466",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3029804",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3193998",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy John Powell, MD
• Monica Pauline Powers, FNP
• Paige Powers
• Rickman Powers
• Precision Cardiac Anesthesia, PLLC
• Premier Medical Inc
• Premier Pharmacy LLC
• Premiercare Tennessee Inc (Ten Broeck Tennessee)
• Premise Health of Tennessee Medical PC (Cummins Health Center Cookville)
• Zulma Adriana Presley

• Specialist in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.