NPIMap

Organization Active NPI

Imagecare Radiology Associates, LLC

  • Diagnostic Radiology Physician
  • Columbia, SC
National Provider Identifier
1851934186
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
IMAGECARE RADIOLOGY ASSOCIATES, LLC
Practice address
710 Rabon Rd Ste 100
Columbia, SC 29203-8903
Phone
(803) 462-3680
Fax
(803) 462-3690
NPI assigned
Oct 18, 2019
Last updated
Oct 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Authorized official

Name
Melissa Brantley
Title
Administrative Director
Phone
(803) 462-3680

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085N0700X
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X
Diagnostic Ultrasound PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085U0001X

Addresses

Primary practice location

710 Rabon Rd Ste 100
Columbia, SC 29203-8903

Mailing address

710 Rabon Rd Ste 100
Columbia, SC 29203-8903
Phone (803) 462-3680

Electronic endpoints 4

TypeEndpointUseAffiliation
Other URL URL
Other URL URL
Other URL URL
Other URL URL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200318001542 SC Part B Supplier - Clinic/Group Practice 3577991975 Receives reassigned benefits from 2 practitioners
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Locations

710 Rabon Rd
Ste 200
Columbia, SC 29203

905 Main St
Newberry, SC 29108

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571356800000",
    "number": "1851934186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 RABON RD STE 100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038903",
            "telephone_number": "803-462-3680",
            "fax_number": "803-462-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 RABON RD STE 100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038903",
            "telephone_number": "803-462-3680",
            "fax_number": "803-462-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGECARE RADIOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "803-462-3680"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "URL",
            "affiliation": "N",
            "address_1": "710 Rabon Rd Ste 100",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292038903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "URL",
            "affiliation": "N",
            "address_1": "710 Rabon Rd Ste 100",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292038903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "URL",
            "affiliation": "N",
            "address_1": "710 Rabon Rd Ste 100",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292038903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "URL",
            "affiliation": "N",
            "address_1": "710 Rabon Rd Ste 200",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292038903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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.