Lumberton Radiological Associates, PA

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

LUMBERTON RADIOLOGICAL ASSOCIATES, PA

Practice address

209 West 27TH Street
Lumberton, NC 28358-3016

Phone

(910) 738-8222

Fax

(910) 671-0846

NPI assigned

Aug 25, 2005

Organization subpart

Yes

Parent organization

LUMBERTON RADIOLOGICAL ASSOCIATES, P.A.As reported in NPPES

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

Authorized official

Name

William Grover Godwin

Title

Practice Administrator

Phone

(910) 738-8222

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Wellness Imaging Center Doing business as

Part of

Lumberton Radiological Associates PA

Practitioners 1

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

• Boyd Bennett Gasque Jr., M.D.

  • Diagnostic Radiology Physician
  • Lumberton, NC
  • NPI 1952394108
  NPD (past)

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1841283751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1527",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283591527",
            "telephone_number": "910-738-8222",
            "fax_number": "910-671-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 WEST 27TH STREET",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583016",
            "telephone_number": "910-738-8222",
            "fax_number": "910-671-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMBERTON RADIOLOGICAL ASSOCIATES, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUMBERTON RADIOLOGICAL ASSOCIATES, P.A.",
        "enumeration_date": "2005-08-25",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "GODWIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GROVER",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "910-738-8222"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02037",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950357",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902037",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Radiology Clinic/Center in Lumberton, NC
• Providers in Lumberton, NC by specialty
• Radiology Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; 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.