OPEN MRI OF JACKSONVILLE LLC (NPI# 1760527873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760527873 |
| Entity Type | Organization |
| Organization Name | OPEN MRI OF JACKSONVILLE LLC |
| Practice Address |
1600 W Walnut St Jacksonville IL 62650-1136 |
| Mailing Address |
1301 S Koke Mill Rd Springfield IL 62711-9252 |
| Practice Telephone | 2172435831 |
| Practice Fax Number | 2172455420 |
| Mailing Telephone | 2175479100 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2009-10-27 |
| Authorized Official Name | RONALD R ROMANELLI (MD) |
| Authorized Official Telephone | 2175479100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
01495461 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538279104 | Open Mri of Jacksonville LLC | Clinic/Center | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2006-08-30 |
| Street Address |
1600 W WALNUT ST |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650-1136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609873249 | Charles Milton Sheaff | Surgery | 1600 W Walnut St, East Wing 2nd Floor, Jacksonville, IL 62650-1136 | 2005-06-28 |
| 1528690799 | Holly Diane Pennell | Nurse Practitioner | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2020-02-06 |
| 1669004081 | Elizabeth Ann Johnson | Nurse Practitioner | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2020-02-05 |
| 1164053526 | Kayla Christine Vickers | Physical Therapist | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2020-02-03 |
| 1366912040 | Kelsi Lynn Dobson | Social Worker | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2018-11-26 |
| 1114402518 | Michelle Lee Geiss | Nurse Practitioner | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2018-10-02 |
| 1134606858 | Matthew Pulley | Nurse Practitioner | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2018-07-25 |
| 1760994040 | Passavant Memorial Area Hospital Association | Family Medicine | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2017-10-26 |
| 1871002238 | Courtney Howell | Social Worker | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2017-09-28 |
| 1831639194 | Carrie Elizabeth Janus | Nurse Practitioner | 1600 W Walnut St, The Center for Psychiatric Health, Jacksonville, IL 62650-1136 | 2017-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003835208 | Nina L Kazerooni | Radiology | 7908 Monterey Bay Dr, Jacksonville, FL 32256-2934 | 2006-07-19 |
| 1831159235 | Robert S Surratt | Radiology | 7006 Wensley Way, Jacksonville, FL 32217-2673 | 2006-03-28 |
| 1952361313 | Christine A.j. Granfield | Radiology | 4463 Worth Dr E, Jacksonville, FL 32207-7503 | 2006-03-27 |
| 1942260005 | Joseph A Utz | Radiology | 7805 Hunters Grove Rd, Jacksonville, FL 32256-7213 | 2006-03-24 |
| 1811965403 | Clifford H Spohr | Radiology | 14208 Mandarin Rd, Jacksonville, FL 32223-2548 | 2006-03-09 |
| 1881985620 | E Edward Franco Md Pa | Radiology | 2345 Forbes St, Jacksonville, FL 32204-4311 | 2011-04-27 |
| 1639328362 | Carlos A Rojas | Radiology | 4500 San Pablo Rd S, Jacksonville, FL 32224 | 2008-09-18 |
| 1366609570 | Kelly Lynn Cox | Radiology | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2008-05-16 |
| 1538333117 | Ascent Diagnostic Imaging of Jacksonville LLC | Radiology | 5210 Belfort Rd, Ste 130, Jacksonville, FL 32256-6024 | 2008-04-15 |
| 1003976648 | Clyde Whitley Vick IIi | Radiology | 1833 Boulevard, Jacksonville, FL 32206-4382 | 2006-12-12 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
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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.