Active NPI
Beaches Open MRI of PBG LLC
- Diagnostic Radiology Physician
- Palm Beach Gardens, FL
National Provider Identifier
1881783553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- ME0070441
- Legal business name
- BEACHES OPEN MRI OF PBG LLC
- Practice address
- 2701 Pga Blvd
Suite a
Palm Beach Gardens, FL 33410 - Phone
- (561) 627-1111
- Fax
- (561) 627-6677
- NPI assigned
- Oct 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Andrew T Walker, MD
- Title
- Officer
- Phone
- (772) 878-5858
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | ME0058016 | FL | |
| Diagnostic Radiology Physician | 2085R0202X | ME0070441 | FL | Primary |
| Diagnostic Radiology Physician | 2085R0202X | ME0061896 | FL |
Addresses
Primary practice location
2701 Pga Blvd
Suite a
Palm Beach Gardens, FL 33410
Mailing address
2701 Pga Blvd
Suite a
Palm Beach Gardens, FL 33410
Phone (561) 627-1111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| V2937 | Other | FL | BCBS |
Other names 1
- Beaches MRI
National Provider Directory
National Provider DirectoryLocations
2701 Pga Blvd
Ste A
Palm Beach Gardens, FL 33410
Phone (561) 627-1111
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Specialist
- Boynton Beach, FL
- NPI 1730137670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1881783553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 PGA BLVD",
"address_2": "SUITE A",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "33410",
"telephone_number": "561-627-1111",
"fax_number": "561-627-6677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 PGA BLVD",
"address_2": "SUITE A",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "33410",
"telephone_number": "561-627-1111",
"fax_number": "561-627-6677"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEACHES OPEN MRI OF PBG LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-12",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WALKER",
"authorized_official_first_name": "ANDREW",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "772-878-5858",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME0058016",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME0070441",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME0061896",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "V2937",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Beaches MRI",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Palm Beach Gardens, 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.