NPIMap

Organization Active NPI

American Dynamic Imaging LTD

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • San Antonio, TX
National Provider Identifier
1871676643
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
AMERICAN DYNAMIC IMAGING LTD
Practice address
9627 Huebner Rd.
Suite 100
San Antonio, TX 78240-1662
Phone
(210) 690-3400
Fax
(210) 690-3407
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Authorized official

Name
Ms. Gay G Walters
Title
President
Phone
(817) 577-7500

Specialties & licenses 2

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

Addresses

Primary practice location

9627 Huebner Rd.
Suite 100
San Antonio, TX 78240-1662

Mailing address

797 Lonesome Dove TRL
Hurst, TX 76054-6018
Phone (817) 577-7500

Other identifiers 2

IdentifierTypeStateIssuer
0543DCOtherTXBCBS PIN
P00234833OtherTXRAILROAD MEDICARE PIN

Other names 1

  • Physicians Stand Up MRI LTD Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121015000626 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0143266486 Practice locations: San Antonio, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
American Dynamic Imaging2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

9627 Huebner Rd
Ste 100
San Antonio, TX 78240
Phone (210) 690-3400

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1871676643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "797 LONESOME DOVE TRL",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760546018",
            "telephone_number": "817-577-7500",
            "fax_number": "817-577-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9627 HUEBNER RD.",
            "address_2": "SUITE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401662",
            "telephone_number": "210-690-3400",
            "fax_number": "210-690-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN DYNAMIC IMAGING LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "GAY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-577-7500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "0543DC",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00234833",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Stand Up MRI LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.