Organization Active NPI

Valley Vascular Imaging

  • Specialist
  • Kingston, PA
National Provider Identifier
1801864673
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
VALLEY VASCULAR IMAGING
Practice address
540 Pierce St
Kingston, PA 18704-5751
Phone
(570) 718-0101
NPI assigned
Mar 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Authorized official

Name
Dr. Brian Marien, M.D.
Title
Owner
Phone
(570) 718-0101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X PA Primary

Addresses

Primary practice location

540 Pierce St
Kingston, PA 18704-5751

Mailing address

540 Pierce St
Kingston, PA 18704-5751
Phone (570) 718-0101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050808000334 PA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4981633294 Practice locations: Kingston, PA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340323200000",
    "number": "1801864673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 PIERCE ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045751",
            "telephone_number": "570-718-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 PIERCE ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045751",
            "telephone_number": "570-718-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY VASCULAR IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2012-06-22",
        "status": "A",
        "authorized_official_last_name": "MARIEN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-718-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; 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.