INDIANA MRI, LLC (NPI# 1790875706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790875706 |
Entity Type | Organization |
Organization Name | INDIANA MRI, LLC |
Practice Address |
3802 Industrial Blvd Suite 4 Bloomington IN 47403-5141 |
Mailing Address |
3900 S Walnut St Bloomington IN 47401-7393 |
Practice Telephone | 8123317727 |
Practice Fax Number | 8123318983 |
Mailing Telephone | 8123360056 |
Mailing Fax Number | 8123360059 |
Enumeration Date | 2006-10-13 |
Last Update Date | 2007-12-07 |
Authorized Official Name | OWEN LAUER (MANAGING MEMBER) |
Authorized Official Telephone | 8123360056 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 100185020A | 05 | |
IN | ANTHEM | 000000221951 | 01 |
Street Address |
3802 INDUSTRIAL BLVD SUITE 4 |
City | BLOOMINGTON |
State | IN |
Zip Code | 47403-5141 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
Find all providers in zip 47403 |
Taxonomy Code | 261QM1200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Magnetic Resonance Imaging (MRI) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992826473 | Eastland Open Mri LLC | Clinic/Center | 1505 Eastland Dr, Lower Level, Bloomington, IL 61701-3534 | 2007-04-03 |
1538236179 | Alliance Healthcare Services Inc | Clinic/Center | 1701 E College Ave, Bloomington, IL 61704-2101 | 2006-11-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992262695 | Munster Medical Imaging Inc | Clinic/Center | 625 Ridge Rd Ste A, Munster, IN 46321-1695 | 2019-02-28 |
1285177980 | Direct Imaging LLC | Clinic/Center | 1355 Getz Rd., Suite B, Fort Wayne, IN 46804-1612 | 2016-11-29 |
1013361377 | Fort Wayne Upright Mri, LLC | Clinic/Center | 6811 Lima Rd, Fort Wayne, IN 46818-1145 | 2016-04-22 |
1396132957 | Easy Mri, Inc. | Clinic/Center | 9921 Coldwater Rd, Fort Wayne, IN 46825-2041 | 2015-04-22 |
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 |
Find all providers with the same taxonomy |
City | BLOOMINGTON |
Zip Code | 47403 |
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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.