INDIANA MRI OF LAFAYETTE LLC (NPI# 1669475687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669475687 |
Entity Type | Organization |
Organization Name | INDIANA MRI OF LAFAYETTE LLC |
Other Organization Name | OPEN MRI OF LAFAYETTE |
Practice Address |
130 Professional Ct Ste C Lafayette IN 47905-5153 |
Practice Telephone | 7654497984 |
Practice Fax Number | 7654499791 |
Mailing Telephone | 7654497984 |
Mailing Fax Number | 7654499791 |
Enumeration Date | 2005-05-23 |
Last Update Date | 2008-06-12 |
Authorized Official Name | MRS. MICHELLE DOUGLAS (CREDENTIALING MANAGER) |
Authorized Official Telephone | 5024031401 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 200134270 | 05 |
Other Name | Type Code |
---|---|
Open MRI of Lafayette | Doing Business As Name - Organization |
Street Address |
130 PROFESSIONAL CT STE C |
City | LAFAYETTE |
State | IN |
Zip Code | 47905-5153 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912363268 | Jolynne Anderson | Nurse Practitioner | 130 Professional Ct, Suite D, Lafayette, IN 47905-5153 | 2015-12-31 |
1093101073 | Patricia Wozniak | Physician Assistant | 130 Professional Ct, Suite D, Lafayette, IN 47905-5153 | 2015-04-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
Find all providers in zip 47905 |
Taxonomy Code | 261QM1200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Magnetic Resonance Imaging (MRI) |
Definition to come... |
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1427334671 | Boulder Mri, LLC | Clinic/Center | 1000 W South Boulder Rd, Ste: 105, Lafayette, CO 80026-2752 | 2011-11-01 |
1386816759 | Imaging Services of Louisiana LLC | Clinic/Center | 5000 Ambassador Caffery Parkway Bldg 10, Lafayette, LA 70508 | 2008-03-26 |
1093784761 | Advanced Imaging of Lafayette LLC | Clinic/Center | 935 Camellia Blvd, Suite 101, Lafayette, LA 70508-7084 | 2006-03-15 |
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1972829372 | Elevated Diagnostic Imaging and Pain Management Center LLC | Clinic/Center | 1642 Olive Branch Park Ln, Greenwood, IN 46143-6447 | 2010-04-12 |
1023201316 | Community Open Mri of Auburn LLC | Clinic/Center | 2428 Lake Ave, Fort Wayne, IN 46805-5406 | 2007-08-21 |
1447340351 | Indiana Mri of Terre Haute, LLC | Clinic/Center | 4313 S 7th St, Terre Haute, IN 47802-4365 | 2006-10-13 |
1417971177 | Community Open Mri of Auburn, LLC | Clinic/Center | 411 Smith Dr, Auburn, IN 46706-3655 | 2006-07-27 |
1831119213 | Binford Imaging & Diagnostic Center LLC | Clinic/Center | 5500 East 65th St, Ste 100, Indianapolis, IN 46220 | 2006-07-20 |
1609811769 | Opensided Mri of Louisville, LLC | Clinic/Center | 120 W Court Ave, Jeffersonville, IN 47130 | 2006-06-20 |
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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.