NPIMap

Organization Active NPI

Jefferson University Radiology Associates, LLC

  • Radiology Clinic/Center
  • Marlton, NJ
National Provider Identifier
1972169902
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES, LLC
Practice address
999 NJ-73
# 101
Marlton, NJ 08053
Phone
(856) 424-2929
NPI assigned
May 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Authorized official

Name
Amy Stout
Title
President/Ceo
Phone
(615) 261-2306

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

999 NJ-73
# 101
Marlton, NJ 08053

Mailing address

800 Crescent Centre Dr Ste 400
Franklin, TN 37067-7270
Phone (615) 261-2306

Other names 1

  • Jefferson Outpatient Imaging Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY, VA, AL4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20190924002409 NJ Part B Supplier - Clinic/Group Practice 7315845708 Receives reassigned benefits from 91 practitioners
1 other NPI on this enrollment
Practice locations: Marlton, NJ; Sewell, NJ
O20231104000087 NY Part B Supplier - Clinic/Group Practice 7315845708 Receives reassigned benefits from 1 practitioner
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Southampton, NY
O20240202002916 VA Part B Supplier - Clinic/Group Practice 7315845708 Receives reassigned benefits from 1 practitioner
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mechanicsville, VA
O20250617001561 AL Part B Supplier - Clinic/Group Practice 7315845708 Receives reassigned benefits from 1 practitioner
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vestavia Hills, AL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jefferson University Radiology Associates LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 92

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 92

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1972169902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR STE 400",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677270",
            "telephone_number": "615-261-2306",
            "fax_number": "855-588-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 NJ-73",
            "address_2": "# 101",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-424-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-15",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "615-261-2306"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Outpatient Imaging",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jefferson Outpatient Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.