Open MRI on 280, LLC

Primary specialty

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

Legal business name

OPEN MRI ON 280, LLC

Doing business as

ImageSouth Homewood

Practice address

1 Independence PLZ Ste 140
Homewood, AL 35209-2629

Phone

(205) 870-1979

Fax

(205) 870-1929

NPI assigned

Jan 30, 2006

Last updated

Oct 28, 2020By 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

Traci Brown

Title

Director of Billing

Phone

(706) 256-3450

Specialties & licenses 1

Addresses

Other identifiers 10

Other names 1

• ImageSouth Homewood Doing business as

Locations

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1801867890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932602",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932602",
            "telephone_number": "205-870-1979",
            "fax_number": "205-870-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PLZ STE 140",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352092629",
            "telephone_number": "205-870-1979",
            "fax_number": "205-870-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN MRI ON 280, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "706-256-3450"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529913290",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N. MELINDA BERGQUIST, MD",
            "identifier": "1023040409",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RUTH SNOW, MD",
            "identifier": "1124000344",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC - PROVIDER NUMBER",
            "identifier": "1600679",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "470001761",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - FACILITY ID #",
            "identifier": "51511247",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JAMES SPANN, M.D, NPI  #",
            "identifier": "1306051164",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROBERT EICHELBERGER, MD",
            "identifier": "1427030642",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. CECIL ELAND - NPI NUMBER",
            "identifier": "1235111451",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JAMES SPANN, M.D. - BCBS ID #",
            "identifier": "51116995",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ImageSouth Homewood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Magnetic Resonance Imaging (MRI) Clinic/Center in Homewood, AL
• Providers in Homewood, AL by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.