Med Image Management & Consultants LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

1004 Issued in LA

Legal business name

MED IMAGE MANAGEMENT & CONSULTANTS LLC

Doing business as

American Mobile Medical of Acadiana

Practice address

174 Grant Rd
Opelousas, LA 70570-0720

Phone

(337) 594-9637

Fax

(337) 948-4556

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Calvin Dale Vidrine, CRA RT R NNPI 1639122195

Title

President Ceo

Phone

(337) 594-9637

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• American Mobile Medical of Acadiana Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Portable X-ray supplier certification: CCN 19X0009824

Legal name

AMERICAN MOBILE MEDICAL OF ACADIANA

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Mar 27, 1995

Last certification

Dec 13, 2018

Ownership / control type

Corporation

Most recent change of ownership

Feb 16, 2022

Facility address

174 Grant Road
Opelousas, LA 70570

Locations

Practitioners 2

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

• Calvin Dale Vidrine, CRA RJ RN

  • Diagnostic Radiology Physician
  • Opelousas, LA
  • NPI 1639122195
  NPD Authorized official
• Richard G. Lastrapes, M.D.

  • Diagnostic Radiology Physician
  • El Segundo, CA
  • NPI 1821081803
  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1730161936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 GRANT RD",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705700720",
            "telephone_number": "337-594-9637",
            "fax_number": "337-948-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 GRANT RD",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705700720",
            "telephone_number": "337-594-9637",
            "fax_number": "337-948-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED IMAGE MANAGEMENT & CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "VIDRINE",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "337-594-9637",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRA RT R N"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "1004",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "1005",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1664669",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT MEDIC",
            "identifier": "P00238881",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Mobile Medical of Acadiana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Martin McCready, DC
• Jeffrey Brennan McGee, PTA
• Erica McManus, ST
• Erica Lafountaine Meche
• Justin Matthew Meche, M.D.
• Jacqueline Melancon, FNP
• Trichelle Melancon, O.D.
• Eleonore A Menard, LMT
• Brandi Noel Menier
• Robert L Menuet II, M.D.

• Diagnostic Radiology Physician in Opelousas, LA
• Providers in Opelousas, LA by specialty
• Diagnostic Radiology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.