Indiana Open MRI LLC

Primary specialty

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

License

N/A

Legal business name

INDIANA OPEN MRI LLC

Practice address

1265 Wayne Ave
Suite 305
Indiana, PA 15701-3501

Phone

(724) 349-3110

Fax

(724) 349-3149

NPI assigned

Feb 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jace D Keller

Title

Treasurer

Phone

(724) 925-2280

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780655282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 450",
            "city": "NEW STANTON",
            "state": "PA",
            "postal_code": "156720450",
            "telephone_number": "724-925-2330",
            "fax_number": "724-925-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 WAYNE AVE",
            "address_2": "SUITE 305",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013501",
            "telephone_number": "724-349-3110",
            "fax_number": "724-349-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA OPEN MRI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "JACE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "724-925-2280",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012169940001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCBS",
            "identifier": "1689483",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Indiana Ekg Associates Inc
• Indiana Eye Care,Inc
• Indiana Healthcare Physician Services Inc
• Indiana Healthcare Physician Services Inc
• Indiana Healthcare Physician Services, Inc
• Indiana Pediatric Associates, P C a
• Indiana Pediatric Associates, PC
• Indiana Pychology Associates, Inc.
• Indiana Regional Imaging, PC
• Indiana Regional Medical Center

• All providers in Indiana, PA
• Magnetic Resonance Imaging (MRI) Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.