NPIMap

Organization Active NPI

Proscan Imaging of Louisville LLC

Doing business as ProScan Imaging St Matthews

  • Diagnostic Radiology Physician
  • Louisville, KY
National Provider Identifier
1972657104
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PROSCAN IMAGING OF LOUISVILLE LLC
Doing business as
ProScan Imaging St Matthews
Practice address
4044 Dutchmans LN
Louisville, KY 40207-4712
Phone
(502) 491-1313
Fax
(502) 491-1315
NPI assigned
Jan 23, 2007
Last updated
Oct 31, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Authorized official

Name
Karen E Amaya
Title
Chief Administrative Officer
Phone
(513) 924-5174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

4044 Dutchmans LN
Louisville, KY 40207-4712

Mailing address

4044 Dutchmans LN
Louisville, KY 40207-4712
Phone (502) 491-1313

Other names 1

  • ProScan Imaging St Matthews Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060118000607 KY Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6507880481 Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

4044 Dutchmans Ln
Louisville, KY 40207
Phone (502) 491-1313

Practitioners & affiliated clinicians

Practitioners 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477872000000",
    "number": "1972657104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4044 DUTCHMANS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074712",
            "telephone_number": "502-491-1313",
            "fax_number": "502-491-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4044 DUTCHMANS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074712",
            "telephone_number": "502-491-1313",
            "fax_number": "502-491-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSCAN IMAGING OF LOUISVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2016-10-31",
        "status": "A",
        "authorized_official_last_name": "AMAYA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "513-924-5174"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProScan Imaging St Matthews",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.