Ultra Imaging, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

720125 Issued in KY

Legal business name

ULTRA IMAGING, INC.

Practice address

707 Burton Pike
Georgetown, KY 40324

Phone

(859) 254-3766

Fax

(859) 299-3799

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Mary Jo C. Campbell-Washington

Title

Office Manager

Phone

(859) 254-3766

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1770618910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 625",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "40324",
            "telephone_number": "859-254-3766",
            "fax_number": "859-299-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 BURTON PIKE",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "40324",
            "telephone_number": "859-254-3766",
            "fax_number": "859-299-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRA IMAGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL-WASHINGTON",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "859-254-3766",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KY",
            "license": "720125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86102019",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Andrew Douglas Vaneyck, CADC
• Jaime Ison Varney, PMHNP-BC

• Clinical Medical Laboratory in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Clinical Medical Laboratory in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.