NPIMap

Organization Active NPI

Medical Imaging Consultants LLP

  • Diagnostic Radiology Physician
  • Longview, TX
National Provider Identifier
1902864366
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MEDICAL IMAGING CONSULTANTS LLP
Practice address
700 E Marshall Ave
Longview, TX 75601-5580
Phone
(903) 315-2072
Fax
(903) 247-0222
NPI assigned
May 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Authorized official

Name
Jerry Keaton, MD
Title
President
Phone
(903) 918-6525

Specialties & licenses 1

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

Addresses

Primary practice location

700 E Marshall Ave
Longview, TX 75601-5580

Mailing address

1602 Pine Tree Rd
Suite 3
Longview, TX 75604-3273
Phone (903) 759-8886

Other identifiers 7

IdentifierTypeStateIssuer
023218301OtherTXCIDC
093656901OtherTXCOUNTY AGENCY
093656901MedicaidTX
DA2958OtherTXTRAVELERS MEDICARE
00K61QOtherTXBLUE CROSS BLUE SHIELD TX
015922OtherTXTX KIDNEY HEALTH
093656901OtherTXCHIP PROGRAM

National Provider Directory

National Provider Directory

Locations

2010 Bill Owens Pkwy
Longview, TX 75604
Phone (903) 247-3400

1602 Pine Tree Rd
Ste 3
Longview, TX 75604

705 E Marshall Ave
Ste 2000
Longview, TX 75601
Phone (903) 315-2072

Practitioners & affiliated clinicians

Practitioners 5

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": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1902864366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 PINE TREE RD",
            "address_2": "SUITE 3",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756043273",
            "telephone_number": "903-759-8886",
            "fax_number": "903-247-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015580",
            "telephone_number": "903-315-2072",
            "fax_number": "903-247-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL IMAGING CONSULTANTS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "KEATON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-918-6525",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIDC",
            "identifier": "023218301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNTY AGENCY",
            "identifier": "093656901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093656901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "DA2958",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TX",
            "identifier": "00K61Q",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX KIDNEY HEALTH",
            "identifier": "015922",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP PROGRAM",
            "identifier": "093656901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.