NPIMap

Organization Active NPI

Radiology Associates of Tallahassee PA

  • Diagnostic Radiology Physician
  • Panama City Beach, FL
National Provider Identifier
1912725771
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY ASSOCIATES OF TALLAHASSEE PA
Practice address
1002 N Arnold Rd
Ste 101
Panama City Beach, FL 32413-2291
Phone
(850) 238-4100
Fax
(706) 653-1230
NPI assigned
Oct 1, 2024
Last updated
Oct 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Authorized official

Name
John R Detelich
Title
Ceo
Phone
(850) 878-4127

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary
Vascular & Interventional Radiology Physician 2085R0204X

Addresses

Primary practice location

1002 N Arnold Rd
Ste 101
Panama City Beach, FL 32413-2291

Mailing address

PO Box 20747
Tampa, FL 33622-0747
Phone (800) 475-6112

National Provider Directory

National Provider Directory
Tax ID family
Eric H Loevinger6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1912725771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20747",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336220747",
            "telephone_number": "800-475-6112",
            "fax_number": "706-653-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N ARNOLD RD",
            "address_2": "STE 101",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324132291",
            "telephone_number": "850-238-4100",
            "fax_number": "706-653-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF TALLAHASSEE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-09-28",
        "status": "A",
        "authorized_official_last_name": "DETELICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-878-4127"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.