Open MRI, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

OPEN MRI, LLC

Doing business as

Cedar Lake MRI

Practice address

1720C Medical Park Dr
Biloxi, MS 39532-2131

Phone

(228) 354-0251

Fax

(228) 396-3550

NPI assigned

Jun 23, 2005

Last updated

Aug 22, 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

Mr. Randall Penberg

Title

Administrator

Phone

(228) 818-0563

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cedar Lake MRI Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Cedar Lake Open MRI LLC

  dba Cedar Lake MRI

  • Diagnostic Radiology Physician
  • Biloxi, MS
  • NPI 1992078950

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801892831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 789",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395660789",
            "telephone_number": "228-818-0563",
            "fax_number": "228-818-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720C MEDICAL PARK DR",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322131",
            "telephone_number": "228-354-0251",
            "fax_number": "228-396-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENBERG",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "228-818-0563",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08882814",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Lake MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hammed Kehinde Olarinde, M.D.
• Sarah Lynn Olmedo-Johnson
• John Edward Olson, PH.D.
• Qui Phu On
• Onsite Care Solutions LLC (OnSite Care Solutions)
• Richard J Orange, MD
• Jennifer L Orellana
• Christopher Mark Orrell, CRNA, NP, MS
• Zoe Ortega, M.D
• Jane M Osowski, PHD, RD

• Diagnostic Radiology Physician in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Diagnostic Radiology Physician in Mississippi

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