KEARNEY IMAGING CENTER LLC , NPI 1932146099 — KEARNEY (NE)

NPI 1932146099

13+ Years Experience Organization

KEARNEY IMAGING CENTER LLC

05/31/2006
PROVIDER ENUMERATION DATE
04/20/2008
LAST UPDATE DATE
1932146099
NPI NUMBER

About KEARNEY IMAGING CENTER LLC

KEARNEY IMAGING CENTER LLC is a provider established in KEARNEY, NE. The NPI number of KEARNEY IMAGING CENTER LLC is 1932146099 and was assigned on 05/31/2006. The practitioners primary taxonomy code is: 261Q00000X .

Mailing address

  • City: KEARNEY
  • State: NE
  • Postal code: 688482528
  • Phone: 3088652230
  • Fax: 3082382254
  • Address: PO BOX 2528

Primary Practice Address

  • Region : KEARNEY, NE
  • NPI : 1932146099
  • Phone : 3088652680
  • Fax : 3082382254
  • Postalcode : 688472949
  • Address : 3219 CENTRAL AVENUE STE 109

Additional identifiers

  • Identifier: 479068
  • Code / Type : 1 - other
  • Identifier state : KS
  • Identifier issuer: BCBS

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 34732
  • Code / Type : 1 - other
  • Identifier state : NE
  • Identifier issuer : BCBS

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261Q00000X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Contacts:

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  • KEARNEY IMAGING CENTER LLC
  • Address : 3219 CENTRAL AVENUE STE 109
  • Region : KEARNEY, NE
  • NPI : 1932146099
  • Phone : 3088652680
  • Fax : 3082382254
  • Postalcode : 688472949

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 3088657555
  • Title or position : VICE CHAIRPERSON
  • Credentials : MD

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address3219 CENTRAL AVENUE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSTE 109
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameKEARNEY
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNE
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code688472949
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3088652680
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3082382254
The fax number associated with the location address of the provider being identified.
NPI1932146099
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261Q00000X
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Provider Enumeration Date05/31/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated04/20/2008
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)KEARNEY IMAGING CENTER LLC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing AddressPO BOX 2528
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameKEARNEY
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNE
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code688482528
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3088652230
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number3082382254
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameFUERST
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameDANIEL
The first name of the authorized official
Authorized Official Middle NameL
The middle name of the authorized official
Authorized Official Title or PositionVICE CHAIRPERSON
The title or position of the authorized official
Authorized Official Credential TextMD
Authorized Official Credential Text
Authorized Official Telephone Number3088657555
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261Q00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 1479068
Other Provider Identifier #1
Other Provider Identifier Type 11
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1KS
Other Provider Identifier State #1
Other Provider Identifier Issuer 1BCBS
Other Provider Identifier Issuer #1
Other Provider Identifier 234732
Other Provider Identifier #2
Other Provider Identifier Type 21
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2NE
Other Provider Identifier State #2
Other Provider Identifier Issuer 2BCBS
Other Provider Identifier Issuer #2
X

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