Organization Active NPI

Evansville Radiology PC

  • Diagnostic Radiology Physician
  • Evansville, IN
National Provider Identifier
1891782983
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
EVANSVILLE RADIOLOGY PC
Practice address
350 W Columbia St
Suite 420
Evansville, IN 47710-1782
Phone
(812) 422-3254
Fax
(812) 426-6388
NPI assigned
Oct 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Dr. Lee Hoagland, MDNPI 1487641544
Title
President
Phone
(812) 422-3254

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X

Addresses

Primary practice location

350 W Columbia St
Suite 420
Evansville, IN 47710-1782

Mailing address

350 W Columbia St
Suite 420
Evansville, IN 47710-1782
Phone (812) 422-3254

Other identifiers 3

IdentifierTypeStateIssuer
0001891782983MedicaidIL
100282640AMedicaidIN
65903163MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MO, CA, PR, KY, TN, HI, VA, AZ, FL, OK, NC, WA13 enrollments

Enrollment records 13

Enrollment IDStateProvider typePAC IDDetails
O20040729001191 IN Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 30 practitioners
Practice locations: Mount Vernon, IN; Newburgh, IN; Princeton, IN; Rockport, IN; Vincennes, IN; Washington, IN; Evansville, IN; Monroe City, IN
O20180502002870 MO Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 1 practitioner
Practice locations: Kansas City, MO; Creve Coeur, MO
O20190912003511 CA Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 1 practitioner
Practice locations: Mission Viejo, CA
O20200526001556 PR Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 1 practitioner
Practice locations: Dorado, PR
O20200803002559 KY Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 29 practitioners
Practice locations: Dixon, KY; Henderson, KY; Morganfield, KY
O20230419001783 TN Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 1 practitioner
Practice locations: Old Hickory, TN
O20230816003816 HI Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 1 practitioner
Practice locations: Makawao, HI
O20231205002978 VA Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 3 practitioners
Practice locations: Gainesville, VA; Middleburgh, VA
O20240715002721 AZ Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 1 practitioner
Practice locations: Flagstaff, AZ
O20241008003526 FL Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 1 practitioner
Practice locations: Windermere, FL
O20241009002919 OK Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 2 practitioners
Practice locations: Ramona, OK; Tulsa, OK
O20260213003613 NC Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 1 practitioner
Practice locations: Pisgah Forest, NC
O20260316001409 WA Part B Supplier - Clinic/Group Practice 6406826031 Receives reassigned benefits from 1 practitioner
Practice locations: Bellingham, WA

National Provider Directory

National Provider Directory

Locations

2007 W Franklin St
#A
Evansville, IN 47712

520 Mary St
Ste 120
Evansville, IN 47710

2007 W Franklin St
Evansville, IN 47712
Phone (812) 422-7244

1900 W 4th St
#6
Mount Vernon, IN 47620

1900 W 4th St
Ste 6
Mount Vernon, IN 47620
Phone (812) 838-2053

1813 Willow St
Unit 3A
Vincennes, IN 47591
Phone (812) 885-8941

406 N 1st St
Vincennes, IN 47591
Phone (812) 882-1106

2005 State St
Washington, IN 47501
Phone (812) 254-4016

Practitioners & affiliated clinicians

Practitioners 51

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

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1891782983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W COLUMBIA ST",
            "address_2": "SUITE 420",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101782",
            "telephone_number": "812-422-3254",
            "fax_number": "812-426-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W COLUMBIA ST",
            "address_2": "SUITE 420",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101782",
            "telephone_number": "812-422-3254",
            "fax_number": "812-426-6388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANSVILLE RADIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "HOAGLAND",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-422-3254",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001891782983",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100282640A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65903163",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.