Indiana MRI, LLC

Primary specialty

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

Legal business name

INDIANA MRI, LLC

Practice address

3802 Industrial Blvd
Suite 4
Bloomington, IN 47403-5141

Phone

(812) 331-7727

Fax

(812) 331-8983

NPI assigned

Oct 13, 2006

Last updated

Dec 7, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Owen Lauer

Title

Managing Member

Phone

(812) 336-0056

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Erich J Weidenbener, M.D.

  • Sports Medicine (Internal Medicine) Physician
  • Bloomington, IN
  • NPI 1811049380
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1790875706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 S WALNUT ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474017393",
            "telephone_number": "812-336-0056",
            "fax_number": "812-336-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 INDUSTRIAL BLVD",
            "address_2": "SUITE 4",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035141",
            "telephone_number": "812-331-7727",
            "fax_number": "812-331-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "LAUER",
        "authorized_official_first_name": "OWEN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "812-336-0056"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100185020A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000221951",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Indiana Detox LLC
• Indiana Emergency Dental Bloomington LLC (Indiana Emergency Dental)
• Indiana Evaluation Services
• Indiana Hearing LLC (Miracle Ear)
• Indiana Home Health Care Corp.
• Indiana Safety Professionals (Assisted Medical Transport Services)
• Indiana Specialty Surgery Center, LLC (Indiana Specialty Surgery Center)
• Indiana Spine and Sports Inc.
• Indiana Telepsych NP, LLC
• Indiana University (Atwater Eye Care Center)

• Magnetic Resonance Imaging (MRI) Clinic/Center in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.