ST VINCENT NORTHWEST RADIOLOGY LLC NPI 1114978350

NPI Information

NPI: 1114978350
Provider Name: ST VINCENT NORTHWEST RADIOLOGY LLC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 15D1087096

Address:
11201 USA PKWY
SUITE 140
FISHERS, IN
ZIP 46037
Phone: (317) 913-8910
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ST VINCENT NORTHWEST RADIOLOGY LLC is a diagnostic radiology radiology in Fishers, IN. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. ST VINCENT NORTHWEST RADIOLOGY LLC NPI is 1114978350. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11201 USA PKWY
SUITE 140
FISHERS, IN
ZIP 46037-202
Phone: (317) 913-8910

The provider's authorized official is Linda A Wilgus .
The authorized official title is Executive Director and has the following contact phone number (317) 328-5050.

The CLIA number assigned to this NPI record is 15D1087096 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 6/18/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200182900	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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