BAY RADIOLOGY WOMENS IMAGING CENTER LLC (NPI# 1558537514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558537514 |
| Entity Type | Organization |
| Organization Name | BAY RADIOLOGY WOMENS IMAGING CENTER LLC |
| Practice Address |
330 W. 23rd St. Panama City FL 32405-7614 |
| Mailing Address |
Po Box 1770 Panama City FL 32402-1770 |
| Practice Telephone | 8507632451 |
| Practice Fax Number | 8507474908 |
| Mailing Telephone | 8507474905 |
| Mailing Fax Number | 8507474907 |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2009-12-31 |
| Authorized Official Name | DR. LLOYD G. LOGUE (CEO) |
| Authorized Official Telephone | 8507632451 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | Y |
| Parent Organization Name | BAY RADIOLOGY ASSOCIATES, PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | V2983 | 01 |
| FL | 000969700 | 05 |
| Street Address |
330 W. 23RD ST. |
| City | PANAMA CITY |
| State | FL |
| Zip Code | 32405-7614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275560765 | George J Parell | Specialist | 330 W. 23rd St., Suite E, Panama City, FL 32405-7614 | 2006-06-28 |
| 1720238769 | Bay Radiology Womens Imaging Center, LLC | Radiology | 330 W. 23rd St., Panama City, FL 32405-7614 | 2008-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457962136 | Kimberlea Fox | Behavioral Analyst | 4750 Collegiate Drive, Technology Building 157, Panama City, FL 32405 | 2020-08-14 |
| 1598325714 | Covenant Home Health Care, LLC | Home Health | 107 W. 19th Street, Panama City, FL 32405 | 2019-06-19 |
| 1467921403 | Amy Hancock | Counselor | 1212 W. 19th St., Panama City, FL 32405 | 2018-11-20 |
| 1063991917 | Patricia Kagendo Mutunga | Day Training, Developmentally Disabled Services | 2813 Fairmont Dr, Panama City, FL 32405 | 2018-08-11 |
| 1871087882 | Southeastern Dermatology Group Pa | Pharmacy | 2505 Harrison Ave Ste A, Panama City, FL 32405 | 2018-06-22 |
| 1346733615 | Jessica Nicole Graham | Nurse Practitioner | 2507 Harrison Ave Unit 101, Panama City, FL 32405 | 2018-06-12 |
| 1437658424 | Coastal Mobility Transportation, LLC | Non-emergency Medical Transport (VAN) | 203 Forest Park Circle, Panama City, FL 32405 | 2018-02-06 |
| 1003314915 | The Anti-aging Clinic of Northwest Florida | Obstetrics & Gynecology | 3019 Osprey Cir, Panama City, FL 32405 | 2018-01-25 |
| 1255848487 | Sarah Theriot | Social Worker | 700 W 23rd St Bldg H, Panama City, FL 32405 | 2018-01-09 |
| 1336686054 | Angela Leake | Registered Nurse | 449 W 23 St, Panama City, FL 32405 | 2017-01-20 |
| Find all providers in zip 32405 | ||||
| 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 |
|---|---|---|---|---|
| 1104851120 | Julie M Miller | Radiology | 330 W 23rd St, Panama City, FL 32405-7614 | 2006-07-11 |
| 1982638466 | Martin Engwall Sheline | Radiology | 527 N. Palo Alto Ave, Panama City, FL 32401-3639 | 2006-07-10 |
| 1841226461 | Ibrahim Arafa Elkomy | Radiology | 1304 Harrison Ave, Panama City, FL 32401-2435 | 2006-06-24 |
| 1225096936 | Florida Diagnostic Imaging Center Inc | Radiology | 2525 Martin Luther King Jr. Blvd, Panama City, FL 32405-4414 | 2006-05-02 |
| 1538136395 | Bay Radiology Associates, Pl | Radiology | 527 N. Palo Alto Ave., Panama City, FL 32401-3639 | 2006-03-01 |
| 1669458246 | Chun Wen Chen | Radiology | 527 N Palo Alto Ave, Panama City, FL 32401-3639 | 2005-12-15 |
| 1942511456 | Amanda Beth Johnson | Radiology | 527 N Palo Alto Ave, Panama City, FL 32401 | 2010-06-30 |
| 1720238769 | Bay Radiology Womens Imaging Center, LLC | Radiology | 330 W. 23rd St., Panama City, FL 32405-7614 | 2008-09-26 |
| 1104087105 | Bettina Anne-margaret Gaycken | Radiology | 527 N Palo Alto Ave, Panama City, FL 32401-3639 | 2008-06-23 |
| 1669630216 | Kunal Pankaj Jani | Radiology | 527 N Palo Alto Ave, Panama City, FL 32401-3639 | 2008-05-30 |
| Find all providers in PANAMA CITY | ||||
| City | PANAMA CITY |
| Zip Code | 32405 |
Please comment or provide details below to improve the information on BAY RADIOLOGY WOMENS IMAGING CENTER LLC.
| 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.