NPIMap

Organization Active NPI

Life Diagnostic Imaging LLC

  • Clinic/Center
  • Virginia Beach, VA
National Provider Identifier
1801089800
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LIFE DIAGNOSTIC IMAGING LLC
Practice address
1020 Independence Blvd
Suite 102
Virginia Beach, VA 23455-5500
Phone
(757) 963-6295
NPI assigned
Aug 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
Mr. Drew Lawrence Digeronimo, BBA,RDCS
Title
President
Phone
(757) 963-6295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1020 Independence Blvd
Suite 102
Virginia Beach, VA 23455-5500

Mailing address

1011 Copper Stone Cir
Chesapeake, VA 23320-8274
Phone (757) 617-3398

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1801089800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 COPPER STONE CIR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233208274",
            "telephone_number": "757-617-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 INDEPENDENCE BLVD",
            "address_2": "SUITE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234555500",
            "telephone_number": "757-963-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE DIAGNOSTIC IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "DIGERONIMO",
        "authorized_official_first_name": "DREW",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-963-6295",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BBA,RDCS"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.