Southeast Imaging, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

SOUTHEAST IMAGING, LLC

Practice address

111 Forest Ave.
Suite C
Eufaula, OK 74432

Phone

(405) 945-4710

Fax

(405) 945-4751

NPI assigned

Jul 13, 2017

Last updated

Nov 27, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeremiah Aaron Jansen, M.D.NPI 1780703900

Title

Member

Phone

(405) 249-7672

Specialties & licenses 2

Addresses

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• McAlester Regional Health Center Authority

  dba Southeast Hospice

  • Community Based Hospice Care Agency
  • McAlester, OK
  • NPI 1306203187

  Member Of

  NPD member
• Radiology Associates of Eastern Oklahoma PLLC

  • Diagnostic Radiology Physician
  • Oklahoma City, OK
  • NPI 1134432040

  Member Of

  NPD member

Locations

Practitioners 1

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.

• Jeremiah Aaron Jansen, MD

  • Diagnostic Radiology Physician
  • Okla City, OK
  • NPI 1780703900
  Authorized official Same address or phone

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511740800000",
    "number": "1902328727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 NW 56TH ST.",
            "address_2": "SUITE 206",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73112",
            "telephone_number": "405-945-4710",
            "fax_number": "405-945-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FOREST AVE.",
            "address_2": "SUITE C",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "74432",
            "telephone_number": "405-945-4710",
            "fax_number": "405-945-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-11-27",
        "status": "A",
        "authorized_official_last_name": "JANSEN",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "405-249-7672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "OK",
            "license": null,
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trista D Simmons
• Jenny Kristine Singh, P.A.
• Christie Dianne Singleton, LPN, BA, MED.
• Kelly J Skimbo, LCSW
• Kolton Dale Smith
• Southeastern Oklahoma Family Services (Eufaula Clinic)
• Linda Lea Spray, PA-C
• Schuyler Tackett Steelberg, M.D.
• Stigler Health and Wellness Center Inc (Eufaula Pharmacy)
• Stigler Health and Wellness Center, McIntosh

• Radiology Clinic/Center in Eufaula, OK
• Providers in Eufaula, OK by specialty
• Radiology Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; 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.