NPIMap

Organization Active NPI

Radiology Group Imaging Center, L.L.C.

  • Diagnostic Radiology Physician
  • Davenport, IA
National Provider Identifier
1790745982
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY GROUP IMAGING CENTER, L.L.C.
Practice address
1970 E 53Rd St
Davenport, IA 52807-2710
Phone
(563) 359-3949
NPI assigned
Mar 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Michael A Bohl
Title
Administrator
Phone
(563) 359-3949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1970 E 53Rd St
Davenport, IA 52807-2710

Mailing address

1970 E 53Rd St
Davenport, IA 52807-2710
Phone (563) 359-3949

Other identifiers 2

IdentifierTypeStateIssuer
0256354MedicaidIA
06301OtherBCBS OF IOWA

National Provider Directory

National Provider Directory

Locations

1970 E 53rd St
#1
Davenport, IA 52807
Phone (503) 359-3931

1970 E 53rd St
Ste 2
Davenport, IA 52807

1970 E 53rd St
Davenport, IA 52807
Phone (563) 359-3949

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790745982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072710",
            "telephone_number": "563-359-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072710",
            "telephone_number": "563-359-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY GROUP IMAGING CENTER, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOHL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "563-359-3949"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0256354",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IOWA",
            "identifier": "06301",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • 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.