NPIMap

Organization Active NPI

Mid Rogue Imaging Center

  • Radiology Clinic/Center
  • Grants Pass, OR
National Provider Identifier
1952730871
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MID ROGUE IMAGING CENTER
Practice address
1619 NW Hawthorne Ave Ste 102
Grants Pass, OR 97526-6008
Phone
(541) 472-5154
Fax
(541) 472-5178
NPI assigned
Nov 1, 2013
Last updated
Nov 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Authorized official

Name
Ms. Susan J Scheufele
Title
President
Phone
(541) 472-5754

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1619 NW Hawthorne Ave Ste 102
Grants Pass, OR 97526-6008

Mailing address

1619 NW Hawthorne Ave Ste 102
Grants Pass, OR 97526-6008
Phone (541) 472-5154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140326001282 OR Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032340518 Practice locations: Grants Pass, OR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2140976Mid Rogue Imaging1619 NW Hawthorne Avenue, Suite 102, Grants Pass, OR 97526Certificate of waiverDec 4, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383264000000",
    "number": "1952730871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 NW HAWTHORNE AVE STE 102",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975266008",
            "telephone_number": "541-472-5154",
            "fax_number": "541-472-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 NW HAWTHORNE AVE STE 102",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975266008",
            "telephone_number": "541-472-5154",
            "fax_number": "541-472-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ROGUE IMAGING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-01",
        "last_updated": "2013-11-01",
        "status": "A",
        "authorized_official_last_name": "SCHEUFELE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-472-5754",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.