Active NPI
Bertrand Diagnostic Imaging and Breast Center, Inc.
- Specialist
- Greensboro, NC
National Provider Identifier
1841281631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 20236
- Legal business name
- BERTRAND DIAGNOSTIC IMAGING AND BREAST CENTER, INC.
- Practice address
- 1126 N Church St
Suite 103
Greensboro, NC 27401-1000 - Phone
- (336) 379-0941
- Fax
- (336) 379-7997
- NPI assigned
- Nov 2, 2005
- Last updated
- May 15, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Eileen Kanewske
- Title
- Director PT. Accounts
- Phone
- (512) 340-8114
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 20236 | NC | Primary |
Addresses
Primary practice location
1126 N Church St
Suite 103
Greensboro, NC 27401-1000
Mailing address
PO Box 6730565
Dallas, TX 75373-0001
Phone (866) 613-5807
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890270A | Medicaid | NC | |
| 0270A | Other | NC | BLUE CROSS PROVIDER NUMBE |
National Provider Directory
National Provider DirectoryLocations
3192 Walden Ln
Burlington, NC 27215
Phone (336) 538-1169
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Diagnostic Radiology Physician
- Greensboro, NC
- NPI 1356374177
Specialist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210809600000",
"number": "1841281631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6730565",
"city": "DALLAS",
"state": "TX",
"postal_code": "753730001",
"telephone_number": "866-613-5807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 N CHURCH ST",
"address_2": "SUITE 103",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274011000",
"telephone_number": "336-379-0941",
"fax_number": "336-379-7997"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BERTRAND DIAGNOSTIC IMAGING AND BREAST CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-02",
"last_updated": "2008-05-15",
"status": "A",
"authorized_official_last_name": "KANEWSKE",
"authorized_official_first_name": "EILEEN",
"authorized_official_title_or_position": "DIRECTOR PT. ACCOUNTS",
"authorized_official_telephone_number": "512-340-8114",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist",
"state": "NC",
"license": "20236",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890270A",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER NUMBE",
"identifier": "0270A",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.