Organization Active NPI

Medfund LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Bradenton, FL
National Provider Identifier
1861495087
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
License
HCC5210 Issued in FL
Legal business name
MEDFUND LLC
Practice address
6220 Manatee Ave W
Ste 101
Bradenton, FL 34209-2303
Phone
(941) 761-8594
Fax
(941) 761-3815
NPI assigned
May 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Martin J. Kern
Title
Senior Vice President
Phone
(941) 925-3490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X HCC5210 FL Primary

Addresses

Primary practice location

6220 Manatee Ave W
Ste 101
Bradenton, FL 34209-2303

Mailing address

240 N Washington Blvd
Sarasota, FL 34236-5945
Phone (941) 925-3490

Other identifiers 3

IdentifierTypeStateIssuer
V2645OtherFLBCBS PROVIDER NUMBER
3411979OtherAETNA HMO PROVIDER NUMBER
5079697OtherAETNA PPO/POS PROV NUMBER

Other names 1

  • horizon two llc Doing business as

National Provider Directory

National Provider Directory

Locations

6220 Manatee Ave W
Bradenton, FL 34209
Phone (941) 673-6675

6220 Manatee Ave W
Ste 101
Bradenton, FL 34209
Phone (941) 761-8594

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861495087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N WASHINGTON BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342365945",
            "telephone_number": "941-925-3490",
            "fax_number": "951-953-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 MANATEE AVE W",
            "address_2": "STE 101",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342092303",
            "telephone_number": "941-761-8594",
            "fax_number": "941-761-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFUND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KERN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "941-925-3490",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "FL",
            "license": "HCC5210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "V2645",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO PROVIDER NUMBER",
            "identifier": "3411979",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO/POS PROV NUMBER",
            "identifier": "5079697",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "horizon two llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.