Neuroradiance Integrative Health Initiative, LTD

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

NEURORADIANCE INTEGRATIVE HEALTH INITIATIVE, LTD

Practice address

110 Polaris Pkwy Ste 120
Westerville, OH 43082-8028

Phone

(614) 776-0624

Fax

(614) 591-9486

NPI assigned

Nov 7, 2019

Last updated

Nov 7, 2019By 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

Richard Cooper, MD

Title

Owner

Phone

(614) 776-0624

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1750926317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 POLARIS PKWY STE 120",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828028",
            "telephone_number": "614-776-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 POLARIS PKWY STE 120",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828028",
            "telephone_number": "614-776-0624",
            "fax_number": "614-591-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURORADIANCE INTEGRATIVE HEALTH INITIATIVE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-776-0624",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.