Active NPI
Med Tel International Corporation
Doing business as Wide Open Imaging
- Diagnostic Radiology Physician
- Chambersburg, PA
National Provider Identifier
1992839518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 20-48857
- Legal business name
- MED TEL INTERNATIONAL CORPORATION
- Doing business as
- Wide Open Imaging
- Practice address
- 405 Phoenix Dr
Unit a
Chambersburg, PA 17201-4534 - Phone
- (717) 263-4999
- Fax
- (717) 263-5522
- NPI assigned
- Mar 15, 2007
- Last updated
- Jan 14, 2008
- Organization subpart
- Yes
- Parent organization
- MED TEL INTERNATIOANL CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Valla
- Title
- Vice President
- Phone
- (973) 873-9850
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 20-48857 | PA | Primary |
Addresses
Primary practice location
405 Phoenix Dr
Unit a
Chambersburg, PA 17201-4534
Mailing address
1430 Spring Hill Rd
Suite 500
McLean, VA 22102-3000
Phone (703) 287-4189
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0018487550005 | Medicaid | PA |
Other names 1
- Wide Open Imaging
National Provider Directory
National Provider Directory- Part of
- Med Tel International Corporation
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1200268800000",
"number": "1992839518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1430 SPRING HILL RD",
"address_2": "SUITE 500",
"city": "MCLEAN",
"state": "VA",
"postal_code": "221023000",
"telephone_number": "703-287-4189",
"fax_number": "703-448-1807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 PHOENIX DR",
"address_2": "UNIT A",
"city": "CHAMBERSBURG",
"state": "PA",
"postal_code": "172014534",
"telephone_number": "717-263-4999",
"fax_number": "717-263-5522"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MED TEL INTERNATIONAL CORPORATION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MED TEL INTERNATIOANL CORPORATION",
"enumeration_date": "2007-03-15",
"last_updated": "2008-01-14",
"status": "A",
"authorized_official_last_name": "VALLA",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "973-873-9850"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "PA",
"license": "20-48857",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0018487550005",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Wide Open Imaging",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Chambersburg, PA
- Zachary C. McMaster, DC
- Ashley L. McMurtrie-Wyles, PTA
- Anna Kathleen McNamara
- Heather M McNew, RD, LDN
- Melissa Kay McNew, D.C.
- Medexpress Urgent Care, PC - Pennsylvania (MedExpress Urgent Care - Chambersburg)
- Medical Practices of Antietam LLC
- Medical Practices of Antietam LLC
- Luis Augusto Medina Mora, M.D.
- Rahul Mehta, DMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.