NPIMap

Organization Active NPI

Blue Lake Open MRI, LLC

Doing business as Blue Lake Open MRI

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Vestavia, AL
National Provider Identifier
1831915750
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
BLUE LAKE OPEN MRI, LLC
Doing business as
Blue Lake Open MRI
Practice address
3105 Blue Lake Dr
Vestavia, AL 35243-2333
Phone
(205) 915-0740
NPI assigned
Nov 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Dr. Perry Lauren Savage Jr., MDNPI 1750354387
Title
Owner
Phone
(659) 444-4422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary

Addresses

Primary practice location

3105 Blue Lake Dr
Vestavia, AL 35243-2333

Mailing address

3105 Blue Lake Dr
Vestavia, AL 35243-2333

Other names 1

  • Blue Lake Open MRI Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250529001317 AL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6608395900 Practice locations: Vestavia, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1831915750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 BLUE LAKE DR",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 BLUE LAKE DR",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432333",
            "telephone_number": "205-915-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE LAKE OPEN MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "SAVAGE",
        "authorized_official_first_name": "PERRY",
        "authorized_official_middle_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "659-444-4422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Lake Open MRI",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Lake Open MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vestavia, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.