NPIMap

Organization Active NPI

Diaspora Radiology, SC

Doing business as Smart Scan Medical Imaging Wausau

  • Diagnostic Radiology Physician
  • Weston, WI
National Provider Identifier
1861119612
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DIASPORA RADIOLOGY, SC
Doing business as
Smart Scan Medical Imaging Wausau
Practice address
2106 Schofield Ave Ste 7
Weston, WI 54476-2412
Phone
(847) 878-9109
NPI assigned
Oct 24, 2022
Last updated
Oct 24, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
DIASPORA RADIOLOGY, SCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Authorized official

Name
Maria Corona
Title
Senior Director, Operations
Phone
(847) 878-9109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

2106 Schofield Ave Ste 7
Weston, WI 54476-2412

Mailing address

1914 Pine Dr
McHenry, IL 60051-2620
Phone (847) 878-9109

Other names 1

  • Smart Scan Medical Imaging Wausau Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Diaspora Radiology SC4 organizations share this tax ID, including this one
Part of
Diaspora Radiology SC

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1861119612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 PINE DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600512620",
            "telephone_number": "847-878-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 SCHOFIELD AVE STE 7",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544762412",
            "telephone_number": "847-878-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIASPORA RADIOLOGY, SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIASPORA RADIOLOGY, SC",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-23",
        "status": "A",
        "authorized_official_last_name": "CORONA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, OPERATIONS",
        "authorized_official_telephone_number": "847-878-9109"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smart Scan Medical Imaging Wausau",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.