PREMIER MEDICAL IMAGING LLC (NPI# 1821571399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821571399 |
| Entity Type | Organization |
| Organization Name | PREMIER MEDICAL IMAGING LLC |
| Practice Address |
2855 Miller Dr Ste 113 Plymouth IN 46563-8091 |
| Mailing Address |
Po Box 338 La Fontaine IN 46940-0338 |
| Practice Telephone | 7652284660 |
| Mailing Telephone | 7652284660 |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2020-04-17 |
| Authorized Official Name | JACKIE-DEE GARDNER BARTROM (PRESIDENT) |
| Authorized Official Telephone | 7652284660 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300021965 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Premier Medical Imaging LLC | 2110 Osceola Street, Denver, CO 80212 |
| Street Address |
2855 MILLER DR STE 113 |
| City | PLYMOUTH |
| State | IN |
| Zip Code | 46563-8091 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811547748 | Steven N Wolff | Pharmacist | Walmart #1978, 2505 North Oak Drive, Plymouth, IN 46563 | 2019-09-12 |
| 1295280923 | Multi-county Ems LLC | Ambulance | 5034 Redwood Road, Plymouth, IN 46563 | 2016-08-23 |
| 1356473060 | Donna Michelle Eggers | Speech-Language Pathologist | 1915 Lake Avenue, Plymouth, IN 46563 | 2007-03-09 |
| 1629103684 | Marshall County Council On Aging | Home Delivered Meals | 1305 W Harrison Street, Plymouth, IN 46563 | 2007-02-22 |
| 1063561272 | Associates In Clinical Psychology PC | Psychiatric Residential Treatment Facility | 317 West Monroe St, Plymouth, IN 46563 | 2007-01-09 |
| 1316005911 | Michiana Eye Center LLC | Optometrist | 320 Meadow Ln, Plymouth, IN 46563 | 2006-12-05 |
| 1487722948 | Allen Edward Reese | Hearing Instrument Specialist | 322 N. Michigan St., Suite C, Plymouth, IN 46563 | 2006-12-01 |
| 1508932252 | Thomas A Miller | Chiropractor | 1071 Lincolnway E, Plymouth, IN 46563 | 2006-11-27 |
| 1679540991 | Mukesh Garg | Internal Medicine | 2349 Lake Ave Ste 99, Plymouth, IN 46563 | 2006-03-06 |
| 1982686242 | Woodlawn Hospital | Skilled Nursing Facility | 9601 Union Rd, Plymouth, IN 46563 | 2005-11-14 |
| Find all providers in zip 46563 | ||||
| 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 |
|---|---|---|---|---|
| 1144495722 | Andrew Allen Thoreson | Radiology | 2800 Campus Dr Ste 20, Plymouth, MN 55441-2669 | 2008-04-24 |
| 1679787279 | Vinay Ravi | Radiology | 2955 Xenium Ln N Ste 40, Plymouth, MN 55441 | 2007-05-10 |
| 1023103843 | Robert J Scott | Radiology | W7177 County Road Z, Plymouth, WI 53073-3835 | 2006-10-04 |
| 1932119542 | Chris G.w. Bauman | Radiology | 2955 Xenium Ln N, Suite 40, Plymouth, MN 55441-2666 | 2006-08-08 |
| 1417915380 | Gordon K Kanzer | Radiology | 3 Cedarhill Park Dr, Plymouth, MA 02360-2226 | 2006-05-02 |
| 1124562483 | Jordan Physician Associates, Inc. | Radiology | 275 Sandwich St, Plymouth, MA 02360-2183 | 2016-12-06 |
| 1922363084 | Christopher S. Stampe | Radiology | 2800 Campus Dr Ste 20, Plymouth, MN 55441 | 2012-07-05 |
| 1912274572 | Bilal Anwer | Radiology | 2955 Xenium Ln N, Ste 40, Plymouth, MN 55441-2668 | 2011-11-28 |
| 1548413131 | Premier Diagonstic Imaging, Inc | Radiology | 12800 Highway 55, Plymouth, MN 55441-3840 | 2008-10-28 |
| 1629244793 | Colleen W Fine | Radiology | 275 Sandwich St, Plymouth, MA 02360-2183 | 2008-05-07 |
| Find all providers in PLYMOUTH | ||||
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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.