FAYETTEVILLE OPEN MRI, LLC (NPI# 1770532269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770532269 |
| Entity Type | Organization |
| Organization Name | FAYETTEVILLE OPEN MRI, LLC |
| Other Organization Name | OPEN MRI FAYETTEVILLE AN AFFILIATE OF DIAGNOSTIC HEALTH |
| Practice Address |
3186 Village Dr Fayetteville NC 28304-3865 |
| Mailing Address |
2764 Pelham Pkwy Pelham AL 35124-1702 |
| Practice Telephone | 9103232209 |
| Practice Fax Number | 9103239680 |
| Mailing Telephone | 2056855000 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2007-10-25 |
| Authorized Official Name | MRS. SHERI MILLER (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 2056855000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Open MRI Fayetteville an affiliate of Diagnostic Health | Doing Business As Name - Organization |
| Street Address |
3186 VILLAGE DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-3865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326041955 | George A. Binder | Radiology | 3186 Village Dr, Suite 201, Fayetteville, NC 28304-3978 | 2005-05-27 |
| 1740799378 | Larra Ashley Hunt | Nurse Practitioner | 3186 Village Dr, Fayetteville, NC 28304-3978 | 2017-09-27 |
| 1205154465 | Walson Kehinde Metzger | Radiology | 3186 Village Dr, Suite 201, Fayetteville, NC 28304-3978 | 2010-05-12 |
| 1851615405 | Grant Yanagi | Radiology | 3186 Village Dr, Ste 201, Fayetteville, NC 28304-3979 | 2010-03-24 |
| 1245474022 | Medical Imaging Center, LLC | Physiological Laboratory | 3186 Village Dr, Suite 101, Fayetteville, NC 28304-3978 | 2009-04-24 |
| 1346405867 | Lisa Ellen Pack | Radiology | 3186 Village Dr, Ste 201, Fayetteville, NC 28304-3979 | 2008-07-24 |
| 1912075631 | Kirk Shane Russell | Radiology | 3186 Village Dr, Suite 201, Fayetteville, NC 28304-3978 | 2006-12-01 |
| 1730107798 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 3186 Village Dr, Ste 202, Fayetteville, NC 28304-3865 | 2006-07-18 |
| 1073561478 | National Imaging Affiliates of Fayetteville, Inc | Physiological Laboratory | 3186 Village Dr, Fayetteville, NC 28304-3865 | 2006-05-05 |
| 1316948094 | Lisa Hutchison | Physician Assistant | 3186 Village Dr, Suite 201, Fayetteville, NC 28304-3978 | 2005-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245474022 | Medical Imaging Center, LLC | Physiological Laboratory | 3186 Village Dr, Suite 101, Fayetteville, NC 28304-3978 | 2009-04-24 |
| 1073561478 | National Imaging Affiliates of Fayetteville, Inc | Physiological Laboratory | 3186 Village Dr, Fayetteville, NC 28304-3865 | 2006-05-05 |
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|---|---|---|---|---|
| 1457980401 | Duke University Health System | Physiological Laboratory | 401 Irving Pkwy Ste 120, Holly Springs, NC 27540-5301 | 2020-04-02 |
| 1457725889 | Braincare, LLC | Physiological Laboratory | 401 N Tryon St, Ste 1120, Charlotte, NC 28202-2196 | 2015-11-23 |
| 1164846010 | Southern Diagnostic Imaging, Inc. | Physiological Laboratory | 10 Parkside Pl, Asheville, NC 28804-1324 | 2014-02-13 |
| 1154656411 | Regional Health Diagnostics Inc | Physiological Laboratory | 38 Office Park Dr, Jacksonville, NC 28546-3217 | 2009-10-05 |
| 1710136791 | Durham Vamc/duke University Medical Center | Physiological Laboratory | Msrb II 106 Research Dr, Room 2018, Durham, NC 27710-0001 | 2008-09-15 |
| 1598959934 | Pinnacle Health Services of North Carolina, LLC | Physiological Laboratory | 839 Durham Rd, Suite A, Wake Forest, NC 27587-8793 | 2007-08-29 |
| 1780714220 | Metrolina Sleep Services, LLC | Physiological Laboratory | 6428 Bannington Rd, Suite A, Charlotte, NC 28226-1327 | 2007-03-06 |
| 1780784520 | Cga, Inc. | Physiological Laboratory | 3905 Skipton Ct, Raleigh, NC 27606-4448 | 2006-09-22 |
| 1265538342 | Carolina Vascular Laboratory | Physiological Laboratory | 420 5th Ave W, Suite 100, Hendersonville, NC 28739-4202 | 2006-09-15 |
| 1457300089 | Pinnacle Health Services of North Carolina LLC | Physiological Laboratory | 1212 Cedarhurst Dr, Raleigh, NC 27609-5587 | 2006-05-10 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
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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.