NPIMap

Organization Active NPI

Evangelical Rad Assoc LTD

  • Diagnostic Radiology Physician
  • Lewisburg, PA
National Provider Identifier
1790734218
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
EVANGELICAL RAD ASSOC LTD
Practice address
1 Hospital Dr
Lewisburg, PA 17837-9314
Phone
(570) 523-7880
NPI assigned
May 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Authorized official

Name
Dr. James O'Brien, MD
Title
Pres
Phone
(570) 523-7880

Specialties & licenses 1

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

Addresses

Primary practice location

1 Hospital Dr
Lewisburg, PA 17837-9314

Mailing address

1 Hospital Dr
Lewisburg, PA 17837-9314
Phone (570) 523-7880

Other identifiers 1

IdentifierTypeStateIssuer
0010447800012MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1790734218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379314",
            "telephone_number": "570-523-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379314",
            "telephone_number": "570-523-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANGELICAL RAD ASSOC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "570-523-7880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "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": "0010447800012",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.