Organization Active NPI

Salem Radiologists, Inc.

  • Diagnostic Radiology Physician
  • Salem, OH
National Provider Identifier
1952484172
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SALEM RADIOLOGISTS, INC.
Practice address
1995 E State St
Medical Imaging Dept.
Salem, OH 44460-2423
Phone
(330) 337-6140
Fax
(330) 337-1071
NPI assigned
Oct 23, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mrs. Gina S. Dermotta
Title
Manager
Phone
(330) 337-6140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

1995 E State St
Medical Imaging Dept.
Salem, OH 44460-2423

Mailing address

2094 E State St
Suite E
Salem, OH 44460-4409
Phone (330) 337-6140

Other identifiers 3

IdentifierTypeStateIssuer
CB4620OtherOHRAILROAD MEDICARE GROUP N
000000163490OtherOHANTHEM PROVIDER GROUP NUM
0126929MedicaidOH

National Provider Directory

National Provider Directory

Locations

2094 E State St
Ste E
Salem, OH 44460

Practitioners & affiliated clinicians

Practitioners 2

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": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1952484172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2094 E STATE ST",
            "address_2": "SUITE E",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444604409",
            "telephone_number": "330-337-6140",
            "fax_number": "330-337-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 E STATE ST",
            "address_2": "MEDICAL IMAGING DEPT.",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444602423",
            "telephone_number": "330-337-6140",
            "fax_number": "330-337-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM RADIOLOGISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "DERMOTTA",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "330-337-6140",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP N",
            "identifier": "CB4620",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER GROUP NUM",
            "identifier": "000000163490",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0126929",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.