Organization Active NPI

National Radiology PLLC

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1821091125
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1643 Issued in MN
Legal business name
NATIONAL RADIOLOGY PLLC
Practice address
4000 W 76TH St
Ste 160
Edina, MN 55435-5104
Phone
(952) 853-7226
Fax
(952) 831-7555
NPI assigned
May 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Gregory Bruce Snyder, M.D.
Title
Ceo
Phone
(952) 853-7226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 1643 MN Primary

Addresses

Primary practice location

4000 W 76TH St
Ste 160
Edina, MN 55435-5104

Mailing address

4000 W 76TH St
Ste 160
Edina, MN 55435-5104
Phone (952) 853-7226

National Provider Directory

National Provider Directory

Locations

4000 W 76th St
Ste 160
Edina, MN 55435
Phone (952) 853-7226

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821091125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W 76TH ST",
            "address_2": "STE 160",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355104",
            "telephone_number": "952-853-7226",
            "fax_number": "952-831-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W 76TH ST",
            "address_2": "STE 160",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355104",
            "telephone_number": "952-853-7226",
            "fax_number": "952-831-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL RADIOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-853-7226",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "1643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • 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.