Tri-State MRI PTR

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

TRI-STATE MRI PTR

Practice address

1802 6TH Ave
Huntington, WV 25703-1519

Phone

(304) 522-6674

Fax

(304) 522-4647

NPI assigned

Jun 30, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Mary Alice Roberts

Title

Administrative Director

Phone

(304) 522-6674

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1760489256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 494",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257090494",
            "telephone_number": "304-522-6674",
            "fax_number": "304-522-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 6TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031519",
            "telephone_number": "304-522-6674",
            "fax_number": "304-522-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE MRI PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ALICE",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "304-522-6674",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0036348000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0682677",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jazzelle Tribble
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• Magnetic Resonance Imaging (MRI) Clinic/Center in Huntington, WV
• Providers in Huntington, WV by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.