Organization Active NPI

Concept Efl Imaging Center LLC

  • Diagnostic Radiology Physician
  • Lake Worth, FL
National Provider Identifier
1891757480
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CONCEPT EFL IMAGING CENTER LLC
Practice address
2290 10TH Ave N
Suite 101
Lake Worth, FL 33461-6607
Phone
(561) 540-8100
Fax
(561) 493-2261
NPI assigned
Apr 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Authorized official

Name
Wanda Fogarty
Title
VP Imaging Services
Phone
(561) 838-3630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

2290 10TH Ave N
Suite 101
Lake Worth, FL 33461-6607

Mailing address

2290 10TH Ave N
Suite 101
Lake Worth, FL 33461-6607
Phone (561) 540-8100

Other identifiers 1

IdentifierTypeStateIssuer
272322100MedicaidFL

Other names 1

  • Concept Open Imaging Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274140800000",
    "number": "1891757480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 10TH AVE N",
            "address_2": "SUITE 101",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616607",
            "telephone_number": "561-540-8100",
            "fax_number": "561-493-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 10TH AVE N",
            "address_2": "SUITE 101",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616607",
            "telephone_number": "561-540-8100",
            "fax_number": "561-493-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCEPT EFL IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2010-05-18",
        "status": "A",
        "authorized_official_last_name": "FOGARTY",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "VP IMAGING SERVICES",
        "authorized_official_telephone_number": "561-838-3630"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272322100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concept Open Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.