Active NPI
Fort Payne MRI LLC
- Radiology Clinic/Center
- Fort Payne, AL
National Provider Identifier
1730145988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Clinic/Center
- Legal business name
- FORT PAYNE MRI LLC
- Practice address
- 1110 Glenn Blvd SW
Suite 100
Fort Payne, AL 35967-8486 - Phone
- (256) 845-9402
- Fax
- (256) 845-9410
- NPI assigned
- Apr 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James W. Holmes
- Title
- Chief Operating Officer
- Phone
- (337) 291-9161
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | |||
| Radiology Clinic/Center | 261QR0200X | Primary |
Addresses
Primary practice location
1110 Glenn Blvd SW
Suite 100
Fort Payne, AL 35967-8486
Mailing address
1110 Glenn Blvd SW
Suite 100
Fort Payne, AL 35967-8486
Phone (256) 845-9402
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051557560 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060530000225 | AL | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 0941211247 | Practice locations: Fort Payne, AL |
National Provider Directory
National Provider DirectoryLocations
1110 Glenn Blvd SW
Ste 100
Fort Payne, AL 35967
Phone (256) 845-9402
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Montgomery, AL
- NPI 1205808755
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Dubuque, IA
- NPI 1366434078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1772582400000",
"number": "1730145988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 GLENN BLVD SW",
"address_2": "SUITE 100",
"city": "FORT PAYNE",
"state": "AL",
"postal_code": "359678486",
"telephone_number": "256-845-9402",
"fax_number": "256-845-9410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 GLENN BLVD SW",
"address_2": "SUITE 100",
"city": "FORT PAYNE",
"state": "AL",
"postal_code": "359678486",
"telephone_number": "256-845-9402",
"fax_number": "256-845-9410"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FORT PAYNE MRI LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-25",
"last_updated": "2026-03-04",
"certification_date": "2026-03-04",
"status": "A",
"authorized_official_last_name": "HOLMES",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "W.",
"authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
"authorized_official_telephone_number": "337-291-9161"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QR0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "051557560",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Payne, AL
- Fort Payne Hospital Corporation (Dekalb Regional Medical Center)
- Fort Payne Hospital Corporation (DeKalb Regional Medical Center)
- Fort Payne Hospital Corporation (Dekalb Regional Medical Center)
- Fort Payne Hospital Corporation (Dekalb Regional Medical Center)
- Fort Payne Hospital Organization (DeKalb Hospitalist Associates)
- Fort Payne Pediatrics LLC
- Fort Payne Pediatrics, LLC
- Fort Payne Pharmacy LLC
- Fort Payne RHC Corp (DeKalb Clinic)
- Fort Payne Urgent Care, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.