NPIMap

Organization Active NPI

Open Advanced MRI of Vancouver, LLC

  • Diagnostic Radiology Physician
  • Vancouver, WA
National Provider Identifier
1770530560
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
OPEN ADVANCED MRI OF VANCOUVER, LLC
Practice address
221G NE 104TH Ave
#106
Vancouver, WA 98664-4587
Phone
(360) 253-2525
Fax
(360) 253-3611
NPI assigned
May 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Authorized official

Name
Levent Adam
Title
Director of Operations
Phone
(703) 970-2892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

221G NE 104TH Ave
#106
Vancouver, WA 98664-4587

Mailing address

Department 4888
Carol Stream, IL 60122-4888
Phone (503) 657-8663

Other identifiers 2

IdentifierTypeStateIssuer
287749MedicaidOR
7104391MedicaidWA

National Provider Directory

National Provider Directory

Locations

Dept 4888
Carol Stream, IL 60122

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1770530560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT 4888",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601224888",
            "telephone_number": "503-657-8663",
            "fax_number": "503-723-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221G NE 104TH AVE",
            "address_2": "#106",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644587",
            "telephone_number": "360-253-2525",
            "fax_number": "360-253-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN ADVANCED MRI OF VANCOUVER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "ADAM",
        "authorized_official_first_name": "LEVENT",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "703-970-2892"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287749",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7104391",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.