MEDICAL MILE IMAGING (NPI# 1407389596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407389596 |
| Entity Type | Organization |
| Organization Name | MEDICAL MILE IMAGING |
| Practice Address |
3905 E Windsmore Dr Springfield MO 65802 |
| Mailing Address |
3905 E Windsmore Springfield MO 65802 |
| Practice Telephone | 4178648360 |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2017-04-06 |
| Authorized Official Name | DR. DAN T SULLIVAN (PRESIDENT) |
| Authorized Official Telephone | 4178648360 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDICAL MILE IMAGING |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
R4804 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
3905 E WINDSMORE DR |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454549 | Andrea Strauch | Counselor | 2024 W Chestnut Expressway Way, Springfield, MO 65802 | 2020-10-12 |
| 1962968867 | Chad Michael Linck | Specialist/Technologist | 2125 N Glenstone Ave, Springfield, MO 65802 | 2019-02-15 |
| 1790254647 | Meds To Live By | Pharmacist | 1134 N. Scarlett Way, Springfield, MO 65802 | 2018-11-21 |
| 1568945103 | Ficom | Non-Pharmacy Dispensing Site | 1308 North Glenstone Avenue, Springfield, MO 65802 | 2018-09-10 |
| 1982194775 | Karla Caballero | Marriage & Family Therapist | 8627 Montant Fort Way, 145, Sprinfield, MO 65802 | 2018-05-16 |
| 1780191809 | Tiffany Chawntay Coryell | Pharmacist | 1134 North Scarlett Way, Springfield, MO 65802 | 2018-01-10 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1346619103 | Jill A Knight | Occupational Therapist | 1601 E. Pythian, Green Valley State School, Springfield, MO 65802 | 2015-09-22 |
| 1447653258 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3720 E Sunshine St, Springfield, MO 65802 | 2014-10-07 |
| 1134538952 | Susan Palmer | Pharmacist | 1260 E. St. Louis St., Springfield, MO 65802 | 2014-08-06 |
| Find all providers in zip 65802 | ||||
| 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 |
|---|---|---|---|---|
| 1154738961 | Allison Kate Retzer | Radiology | 701 N 1st Box 101, Springfield, IL 62781-0001 | 2014-07-14 |
| 1134552821 | Clinical Radiologists, S.c. | Radiology | 2812 Pat Tillman Dr, Springfield, IL 62711-6410 | 2013-08-16 |
| 1700199668 | Telerad of Mo Account Management, LLC | Radiology | 5117 S. Neffleton Ave, Springfield, MO 65810 | 2010-07-21 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| 1316108434 | Michael C Snyder | Radiology | 2201 Greenside Dr, Springfield, IL 62704-3245 | 2008-06-20 |
| 1245416536 | Mary T Peter | Radiology | Springfield Radiologists St Johns Hospital, 800 E. Carpenter Street, Springfield, IL 62769-0001 | 2008-01-16 |
| 1437361060 | Kal Dulaimy | Radiology | 1350 Main Street Suite 1007, Radiology and Imaging, Inc., Springfield, MA 01103-0000 | 2007-05-04 |
| 1265654164 | Nzeadibenma O Uzochukwu | Radiology | 800 Carpenter St, Springfield, IL 62769-0001 | 2007-05-02 |
| 1396865838 | Charles X Stricker | Radiology | 4303 E Lori Lei Ct, Springfield, MO 65809-3501 | 2007-03-29 |
| 1558400358 | Simon Vladimir Bekker | Radiology | Springfield Radiologists S C, 800 East Carpenter Street, Springfield, IL 62769-0001 | 2007-02-06 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65802 |
Please comment or provide details below to improve the information on MEDICAL MILE IMAGING.
| 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.