Cedar Court Imaging LTD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036091745 Issued in IL

Legal business name

CEDAR COURT IMAGING LTD

Practice address

1200 Cedar CT
Carbondale, IL 62901-5334

Phone

(618) 529-8500

Fax

(618) 549-1000

NPI assigned

Dec 22, 2005

Last updated

Oct 21, 2011By 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

Dr. Douglas L. Fulk, MDNPI 1992780050

Title

President

Phone

(618) 529-8500

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

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.

• Douglas L Fulk, M.D.

  • Diagnostic Radiology Physician
  • Carbondale, IL
  • NPI 1992780050
  NPD Authorized official
• Daniel Raymond Fulk, D.O.

  • Diagnostic Radiology Physician
  • Carbondale, IL
  • NPI 1962432286
  NPD
• James T Barron, M.D.

  • Diagnostic Radiology Physician
  • Herrin, IL
  • NPI 1457338238
  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319155200000",
    "number": "1801873666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CEDAR COURT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015334",
            "telephone_number": "618-529-8500",
            "fax_number": "618-549-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015334",
            "telephone_number": "618-529-8500",
            "fax_number": "618-549-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR COURT IMAGING LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2011-10-21",
        "status": "A",
        "authorized_official_last_name": "FULK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-529-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036091745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091745",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catholic Social Services Carbondale
• Dianne Zuasula Catolos, PT, DPT
• Mary Kay Cattaneo, PT
• Meagan Elizabeth Causey, M.S.
• Melissa Cauthen, LCSW
• Center for Autism Spectrum Disorders
• Center for Comprehensive Services, Inc (Neurorestorative, Illinois)
• Center for Comprehensive Services, Inc. (NeuroRestorative)
• Centerstone of Illinois Inc
• Centerstone of Illinois Inc

• Diagnostic Radiology Physician in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.