NPIMap

Organization Active NPI

General Radiology Associates, P.C.

  • Diagnostic Radiology Physician
  • Mount Clemens, MI
National Provider Identifier
1801801519
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
GENERAL RADIOLOGY ASSOCIATES, P.C.
Practice address
1000 Harrington St
Mount Clemens, MI 48043-2920
Phone
(586) 493-8098
Fax
(586) 493-8706
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Authorized official

Name
Karl Doelle, D.O.NPI 1659316842
Title
President
Phone
(586) 493-8098

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1000 Harrington St
Mount Clemens, MI 48043-2920

Mailing address

PO Box 1108
Attn: Barb Simmons
Ann Arbor, MI 48106-1108
Phone (734) 677-7400

Other identifiers 3

IdentifierTypeStateIssuer
310E011330OtherMIBCBS GRP#
CI8050OtherMIRR MEDICARE
310E011330OtherMIBCN GRP#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000659 MI Part B Supplier - Clinic/Group Practice 4981518644 Receives reassigned benefits from 13 practitioners
Practice locations: Lenox, MI; Mount Clemens, MI; Clinton Township, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1801801519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "address_2": "ATTN: BARB SIMMONS",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481061108",
            "telephone_number": "734-677-7400",
            "fax_number": "734-677-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-8098",
            "fax_number": "586-493-8706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL RADIOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "DOELLE",
        "authorized_official_first_name": "KARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-493-8098",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP#",
            "identifier": "310E011330",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CI8050",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN GRP#",
            "identifier": "310E011330",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.