Organization Active NPI

Lafayette Radiology LLC

  • Diagnostic Radiology Physician
  • Lafayette, IN
National Provider Identifier
1891840062
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
LAFAYETTE RADIOLOGY LLC
Practice address
1501 Hartford St
Lafayette, IN 47904-2134
Phone
(765) 502-4000
Fax
(765) 446-4859
NPI assigned
Jan 25, 2007
Last updated
Mar 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Authorized official

Name
Robert E Mehl, MD
Title
President
Phone
(765) 446-4819

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

1501 Hartford St
Lafayette, IN 47904-2134

Mailing address

3900 St Francis Way
Suite 215
Lafayette, IN 47905-4925
Phone (765) 446-4819

Other identifiers 2

IdentifierTypeStateIssuer
200856080MedicaidIN
DG0872OtherINRR MEDICARE

National Provider Directory

National Provider Directory

Locations

915 Sagamore Pkwy W
West Lafayette, IN 47906
Phone (765) 463-2424

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1891840062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 ST FRANCIS WAY",
            "address_2": "SUITE 215",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054925",
            "telephone_number": "765-446-4819",
            "fax_number": "765-466-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HARTFORD ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042134",
            "telephone_number": "765-502-4000",
            "fax_number": "765-446-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE RADIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "MEHL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-446-4819",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200856080",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DG0872",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.