NPIMap

Organization Active NPI

Middle Tennessee Imaging, LLC

Doing business as Premier Radiology

  • Mobile Radiology Clinic/Center
  • Clarksville, TN
National Provider Identifier
1831597806
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
Legal business name
MIDDLE TENNESSEE IMAGING, LLC
Doing business as
Premier Radiology
Practice address
980 Professional Park Dr
Suite E
Clarksville, TN 37040-5251
Phone
(615) 851-6033
NPI assigned
Dec 8, 2014
Last updated
Dec 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Authorized official

Name
Naomi M Cassin
Title
Avp, Provider Enrollment
Phone
(312) 724-8477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X NU Primary

Addresses

Primary practice location

980 Professional Park Dr
Suite E
Clarksville, TN 37040-5251

Mailing address

PO Box 306512
Nashville, TN 37230-6545
Phone (615) 851-6003

Other names 1

  • Premier Radiology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150618001969 TN Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5698743706 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clarksville, TN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Middle Tennessee Imaging LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

75 Remittance Dr
Dept 6244
Chicago, IL 60675

NPI Registry JSON

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1831597806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306512",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306545",
            "telephone_number": "615-851-6003",
            "fax_number": "615-984-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 PROFESSIONAL PARK DR",
            "address_2": "SUITE E",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405251",
            "telephone_number": "615-851-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE TENNESSEE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-08",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "CASSIN",
        "authorized_official_first_name": "NAOMI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AVP, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "312-724-8477"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Radiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.