NPIMap

Organization Active NPI

Diagnostic Imaging Centers of Nepa, LLC

  • Diagnostic Radiology Physician
  • Matamoras, PA
National Provider Identifier
1992945935
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DIAGNOSTIC IMAGING CENTERS OF NEPA, LLC
Practice address
111 Hulst Dr
Ste 708
Matamoras, PA 18336-2115
Phone
(570) 491-9200
Fax
(570) 491-9201
NPI assigned
Mar 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Mrs. Lori M Bodnar, RCC
Title
Director of Billing/Contracting
Phone
(570) 504-2519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

111 Hulst Dr
Ste 708
Matamoras, PA 18336-2115

Mailing address

1000 Meade St
Medical Plaza
Dunmore, PA 18512-3195
Phone (570) 504-2519

Other names 1

  • Advanced Imaging Specialists Doing business as

National Provider Directory

National Provider Directory

Locations

102 N Abington Rd
Clarks Green, PA 18411
Phone (570) 466-0746

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1992945935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MEADE ST",
            "address_2": "MEDICAL PLAZA",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185123195",
            "telephone_number": "570-504-2519",
            "fax_number": "570-504-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HULST DR",
            "address_2": "STE 708",
            "city": "MATAMORAS",
            "state": "PA",
            "postal_code": "183362115",
            "telephone_number": "570-491-9200",
            "fax_number": "570-491-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC IMAGING CENTERS OF NEPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-04",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "BODNAR",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING/CONTRACTING",
        "authorized_official_telephone_number": "570-504-2519",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RCC"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Imaging Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Matamoras, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.