DURHAM DIAGNOSTIC IMAGING LLC NPI 1821046004

NPI Information

NPI: 1821046004
Provider Name: DURHAM DIAGNOSTIC IMAGING LLC

Doing Business As: INDEPENDENCE PARK

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
4323 BEN FRANKLIN BLVD
DURHAM, NC
ZIP 27704
Phone: (919) 471-4840
Get Directions

DURHAM DIAGNOSTIC IMAGING LLC is a diagnostic radiology radiology in Durham, NC. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DURHAM DIAGNOSTIC IMAGING LLC NPI is 1821046004. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Independence Park.

The provider's business location address is:

4323 BEN FRANKLIN BLVD
DURHAM, NC
ZIP 27704-177
Phone: (919) 471-4840
Fax: (919) 321-1575

The provider's authorized official is Geoffrey K. Gardner .
The authorized official title is Svp Finance And Revenue Cycle and has the following contact phone number (336) 718-2078.

The CLIA number assigned to this NPI record is 34D0999196 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/4/2006 and was last updated on 3/20/2024.

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		NORTH CAROLINA	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	89014E3	MEDICAID	NORTH CAROLINA
2	0187Q	OTHER	NORTH CAROLINA	BCBS NC
3	205314600	OTHER	NORTH CAROLINA	DOL
4	P00014222	OTHER		MEDICARE RR

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: 4/28/2024

NPI Synchronization or Removal

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