NPIMap

Organization Active NPI

Premier Imaging Corporation

  • Diagnostic Ultrasound Physician
  • Freehold, NJ
National Provider Identifier
1962874610
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
License
25MA06928800 Issued in NJ
Legal business name
PREMIER IMAGING CORPORATION
Practice address
900 W Main St
Suite 3
Freehold, NJ 07728-2523
Phone
(732) 308-2255
Fax
(732) 308-0081
NPI assigned
Oct 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Authorized official

Name
Dr. Casandra Autry, M.D.
Title
Director
Phone
(732) 308-2255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085U0001X 25MA06928800 NJ Primary

Addresses

Primary practice location

900 W Main St
Suite 3
Freehold, NJ 07728-2523

Mailing address

900 W Main St
Suite 3
Freehold, NJ 07728-2523
Phone (732) 308-2255

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1962874610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W MAIN ST",
            "address_2": "SUITE 3",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282523",
            "telephone_number": "732-308-2255",
            "fax_number": "732-308-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W MAIN ST",
            "address_2": "SUITE 3",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282523",
            "telephone_number": "732-308-2255",
            "fax_number": "732-308-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER IMAGING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-21",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "AUTRY",
        "authorized_official_first_name": "CASANDRA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-308-2255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NJ",
            "license": "25MA06928800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.