NPIMap

Organization Active NPI

Inmed Diagnostics Services of SC LLC

  • Radiology Clinic/Center
  • Florence, SC
National Provider Identifier
1821114315
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
061715 Issued in SC
Legal business name
INMED DIAGNOSTICS SERVICES OF SC LLC
Practice address
1120 W Evans St
Florence, SC 29501-3320
Phone
(843) 292-0082
Fax
(843) 292-0086
NPI assigned
Mar 22, 2007
Last updated
Jan 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Authorized official

Name
Carmen Restivo
Title
Credentialing Manager
Phone
(352) 241-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 061715 SC Primary

Addresses

Primary practice location

1120 W Evans St
Florence, SC 29501-3320

Mailing address

PO Box 593869
Orlando, FL 32859-3869
Phone (352) 241-6100

Other identifiers 2

IdentifierTypeStateIssuer
470000122OtherSCRR MEDICARE
SL0034MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041115000528 SC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7315901972 Practice locations: Florence, SC

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Inmed Diagnostic Services of SC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

75 Remittance Dr
Dept 6611
Chicago, IL 60675

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1821114315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 593869",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328593869",
            "telephone_number": "352-241-6100",
            "fax_number": "352-241-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W EVANS ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013320",
            "telephone_number": "843-292-0082",
            "fax_number": "843-292-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INMED DIAGNOSTICS SERVICES OF SC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "RESTIVO",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "352-241-6100"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "SC",
            "license": "061715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "470000122",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SL0034",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.