JACKSONVILLE DIAGNOSTIC IMAGING LLC (NPI# 1144451881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144451881 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE DIAGNOSTIC IMAGING LLC |
| Other Organization Name | NCDI-MOBILE 3 |
| Practice Address |
14215 Ballantyne Corporate Pl Charlotte NC 28277-3670 |
| Mailing Address |
Po Box 60598 Charlotte NC 28260-0598 |
| Practice Telephone | 7043841890 |
| Mailing Telephone | 6789927373 |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2010-08-11 |
| Authorized Official Name | MR. DANIEL J SCHAEFER (C.O.O.) |
| Authorized Official Telephone | 7703000101 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| NCDI-Mobile 3 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104874387 | Jacksonville Diagnostic Imaging LLC | Radiology | 3606 Henderson Dr, Jacksonville, NC 28546-5217 | 2006-05-04 |
| Street Address |
14215 BALLANTYNE CORPORATE PL |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277-3670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508828054 | Kerrith Jaeckel | Pediatrics | 14215 Ballantyne Corporate Pl, Suite 130, Charlotte, NC 28277-3671 | 2006-04-03 |
| 1629516067 | Novant Medical Group, Inc | Internal Medicine | 14215 Ballantyne Corporate Pl, Suite 240, Charlotte, NC 28277-3670 | 2017-02-06 |
| 1265870026 | Novant Medical Group, Inc | Internal Medicine | 14215 Ballantyne Corporate Pl, Suite 240, Charlotte, NC 28277-3670 | 2013-06-13 |
| 1194067082 | Elizabeth Ann Bartis | Nurse Practitioner | 14215 Ballantyne Corporate Pl, Suite 130, Charlotte, NC 28277-3670 | 2013-03-19 |
| 1063758142 | Lisa M. Delacruz | Nurse Practitioner | 14215 Ballantyne Corporate Pl, Suite 130, Charlotte, NC 28277-3670 | 2012-12-18 |
| 1255694303 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 14215 Ballantyne Corporate Pl, Suite 110, Charlotte, NC 28277-3670 | 2012-06-22 |
| 1891008652 | Emily C Ciovacco | Physician Assistant | 14215 Ballantyne Corporate Pl, Suite 230, Charlotte, NC 28277-3670 | 2010-07-22 |
| 1407097538 | Sarah Webber Sumrall | Physician Assistant | 14215 Ballantyne Corporate Pl, Suite 230, Charlotte, NC 28277-3670 | 2009-03-19 |
| 1003835398 | Kathy Garland Mohanty | Pediatrics | 14215 Ballantyne Corporate Pl, Suite 130, Charlotte, NC 28277-3670 | 2006-07-18 |
| 1285669804 | Sharon Mcvay O'brien | Physician Assistant | 14215 Ballantyne Corporate Pl, Suite 230, Charlotte, NC 28277-3670 | 2006-07-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
| 1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
| 1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
| 1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
| Find all providers in zip 28277 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003110677 | Charlotte Radiology Pa | Radiology | 1025 Morehead Medical Dr Ste 150, Charlotte, NC 28204-2973 | 2010-12-22 |
| 1144477258 | Presbyterian Imaging Centers LLC | Radiology | 13557 Steelecroft Parkway, Suite 1100, Charlotte, NC 28278 | 2008-08-20 |
| 1801097803 | Orion Imaging, LLC | Radiology | 10420 Park Rd, Ste 100, Charlotte, NC 28210-8501 | 2007-05-29 |
| 1457561912 | John D Wylie | Radiology | 3816 Latrobe Dr, Charlotte, NC 28211-1167 | 2007-05-23 |
| 1417029455 | Gregory John Duellman | Radiology | 14121 Lissadell Cir, Charlotte, NC 28277-3137 | 2006-11-14 |
| 1407926165 | Metrolina Women's Breast Center Pllc | Radiology | 439 N Wendover Road, Charlotte, NC 28211 | 2006-11-09 |
| 1932286523 | Charles Nicholas Pappas | Radiology | 609 Stockbridge Rd, Charlotte, VT 05445-9361 | 2006-11-01 |
| 1164439873 | Kenneth Fox | Radiology | 9935d Rea Rd Ste 266, Charlotte, NC 28277-6710 | 2006-08-02 |
| 1265470421 | Kevin W Carroll | Radiology | 3623 Latrobe Drive, Ste 216, Charlotte, NC 28211 | 2006-06-02 |
| 1528032604 | Diane Huntington Conley | Radiology | 3815 Stoney Ridge Trl, Charlotte, NC 28210-6932 | 2006-02-15 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.