St. Jude Radiology Medical Group, Inc.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

ST. JUDE RADIOLOGY MEDICAL GROUP, INC.

Practice address

8070 Entrada de Luz E
San Diego, CA 92127-2561

Phone

(714) 992-3978

NPI assigned

Jul 18, 2017

Organization subpart

No

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

Authorized official

Name

Bradley Jackson, MD

Title

Medical Director / Ceo

Phone

(714) 992-3978

Specialties & licenses 1

Addresses

Practitioners 2

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

• Manal Mosaad Schoellerman, M.D.

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1821060724
  NPD
• Vishal Verma, MD

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1881613586
  NPD

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500336000000",
    "number": "1790208155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 940",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913190940",
            "telephone_number": "800-317-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8070 ENTRADA DE LUZ E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921272561",
            "telephone_number": "714-992-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUDE RADIOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-07-18",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / CEO",
        "authorized_official_telephone_number": "714-992-3978",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathrine Linda St. Clair, OTR/L
• Jamal Leo St. Cyr, BA
• Lauren St. Hilaire
• Alex St. John
• Amy V. St. John, M.S.P.T.
• Hailee St. Louis
• St. Paul'S Episcopal Home, Inc.
• Michelle Leigh St. Romain, MD
• St. Vincent de Paul Village, Inc
• St. Vincent de Paul Village, Inc

• Diagnostic Radiology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; 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.