ADVANCED DIAGNOSTIC RADIOLOGY PC (NPI# 1922006519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922006519 |
| Entity Type | Organization |
| Organization Name | ADVANCED DIAGNOSTIC RADIOLOGY PC |
| Practice Address |
1301 15th Ave W Williston ND 58801-3821 |
| Mailing Address |
Po Box 2537 Williston ND 58802-2537 |
| Practice Telephone | 7017747401 |
| Mailing Telephone | 8663386472 |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2008-10-17 |
| Authorized Official Name | DR. GLENN P MORADIAN (PRESIDENT) |
| Authorized Official Telephone | 2085570999 |
| Authorized Official Credential | MD |
| 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 |
|---|---|---|---|
| UT | BC OF IDAHO | 8M916 | 01 |
| ND | 15040 | 05 | |
| ID | 807083700 | 05 | |
| ID | BLUE SHIELD NUMBER | 000010149528 | 01 |
| ID | BC NUMBER - IDAHO FALLS | IF - 8L493 | 01 |
| ID | BC NUMBER FOR POCATELLO | POC - 8L501 | 01 |
| Street Address |
1301 15TH AVE W |
| City | WILLISTON |
| State | ND |
| Zip Code | 58801-3821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487251930 | Elizabeth Coulson | Nurse Practitioner | 1301 15th Ave W, Williston, ND 58801-3821 | 2020-10-07 |
| 1700420288 | Heather Rose Hass | Nurse Practitioner | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-10-29 |
| 1740822584 | Anna Elizabeth Wolf | Nurse Practitioner | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-10-14 |
| 1124678297 | Janet Williams | Registered Nurse | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-09-19 |
| 1396394904 | Chelsea Nichole Smith | Advanced Practice Midwife | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-09-06 |
| 1952959868 | Kaleb Barstad | Pharmacist | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-09-04 |
| 1447819586 | Craig D White | Registered Nurse | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-06-12 |
| 1043780828 | Yesul Song | Pharmacist | 1301 15th Ave W, Williston, ND 58801-3821 | 2018-12-05 |
| 1467938399 | Melissa Sue Gilbertson | Physician Assistant | 1301 15th Ave W, Williston, ND 58801 | 2018-07-13 |
| 1346745114 | Deborah L Bronson | Registered Nurse | 1301 15th Ave W, Williston, ND 58801-3821 | 2018-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952868556 | Purpose Driven Interventions | Counselor | 1502 13th Ave West, Williston, ND 58801 | 2019-03-01 |
| 1437637501 | Camille Ann Settelmeyer | Nurse Practitioner | 1213 15th Avenue West, Williston, ND 58801 | 2018-08-01 |
| 1801317417 | Shelby Laine Carlson | Physical Therapist | 1502 13th Ave W Suite 101, Williston, ND 58801 | 2017-07-05 |
| 1710418579 | Catrina Louise Lindvig | Chiropractor | 1135 2nd Ave W Ste 203, Williston, ND 58801 | 2017-03-23 |
| 1801337415 | Selah Counseling | Clinic/Center | 125 Main St, Suite #220, Williston, ND 58801 | 2017-03-15 |
| 1316485634 | Theresa E Scully | Social Worker | 125 Main St; Unit 220, Williston, ND 58801 | 2017-02-07 |
| 1346792256 | Donna Peterson | Social Worker | 1500 14th St Sw, Suite 250, Williston, ND 58801 | 2016-10-26 |
| 1730509084 | Lacey Thompson | Case Manager/Care Coordinator | 110 West Broadway, Suite 202, Williston, ND 58801 | 2014-04-24 |
| 1770904708 | Kayla Jo Rossland | Physical Therapist | 221 University Ave Ste 203, Williston, ND 58801 | 2013-12-17 |
| 1285072710 | Susan Mae Bradford | Counselor | 612 4th St. E., Williston, ND 58801 | 2013-06-06 |
| Find all providers in zip 58801 | ||||
| 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 |
|---|---|---|---|---|
| 1629234257 | Mercy Medical Center | Radiology | 1301 15th Ave W, Williston, ND 58801-3821 | 2008-08-04 |
| 1639389133 | Madhusudhan P Reddy | Radiology | 1301 15th Ave. W., Williston, ND 58801-3821 | 2007-05-23 |
| 1467528455 | Leszek J Jaszczak | Radiology | 3 4th St E, Suite 201, Williston, ND 58801-5350 | 2006-11-28 |
| 1356349955 | Glenn P Moradian | Radiology | 1301 15th Ave W, Williston, ND 58801-3821 | 2005-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710213715 | Henry David Knudsen | Radiology | 3207 46th Ave Se, Mandan, ND 58554-4729 | 2009-10-26 |
| 1104054477 | James Allen Miller | Radiology | #1 Burdick Expy W., Minot, ND 58701-4406 | 2009-06-25 |
| 1992836100 | Robert Lowell Anderson | Radiology | One West Burdick Expressway, Minot, ND 58702-5020 | 2007-03-08 |
| 1841388089 | Garren C Ruggaber | Radiology | 1191 S Columbia Rd, Grand Forks, ND 58201-4033 | 2006-10-11 |
| 1902826340 | Edward F Fogarty | Radiology | 800 Munich Dr, Bismarck, ND 58504-7050 | 2006-07-20 |
| 1346267812 | Francisco V Ouano | Radiology | 2907 32nd St S, Fargo, ND 58103-7863 | 2006-07-17 |
| 1114942372 | Kathleen Ann Wood | Radiology | 705 13th Ave N, Apt. 310, Fargo, ND 58102-2680 | 2006-07-12 |
| 1376578484 | Royce L Zobell | Radiology | #1 Burdick Expy W, Minot, ND 58701 | 2006-07-11 |
| 1003899584 | Radiology Services, P.a. | Radiology | 419 5th St Ne, Jamestown, ND 58401-3300 | 2005-11-29 |
| 1366423618 | Prairie Imaging, PC | Radiology | 112 3rd St W, Dickinson, ND 58601-5136 | 2005-11-11 |
| Find all providers with the same taxonomy | ||||
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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.