MECKLENBURG DIAGNOSTIC IMAGING LLC NPI 1093773384

NPI Information

  • NPI: 1093773384
  • Provider Name: MECKLENBURG DIAGNOSTIC IMAGING LLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Doing Business As: NOVANT HEALTH IMAGING SOUTHPARK
  • CLIA Number: 34D1014535
  • Address: 6324 FAIRVIEW RD
    SUITE 120 A
    CHARLOTTE, NC
    ZIP 28210
  • Phone: (704) 362-8444

Map and Directions

Get Directions

NPI Details

MECKLENBURG DIAGNOSTIC IMAGING LLC is a diagnostic radiology radiology in Charlotte, NC. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MECKLENBURG DIAGNOSTIC IMAGING LLC NPI is 1093773384. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Novant Health Imaging Southpark.

The provider's business location address is:

6324 FAIRVIEW RD
SUITE 120 A
CHARLOTTE, NC
ZIP 28210-200
Phone: (704) 362-8444
Fax: (704) 362-3557

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 34D1014535 - other with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml (HCPCS:Q9967)
  • Injection, gadobutrol, 0.1 ml (HCPCS:A9585)
  • Screening 3d breast mammography (HCPCS:77063)
  • Screening mammography (HCPCS:77067)
  • Dxa bone density measurement of hip, pelvis, spine (HCPCS:77080)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Ct scan of abdomen and pelvis with contrast (HCPCS:74177)
  • Ct scan of chest without contrast (HCPCS:71250)
  • Ct scan of chest with contrast (HCPCS:71260)
  • Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) (HCPCS:G0279)
  • Mri scan of lower spinal canal without contrast (HCPCS:72148)
  • Mri scan of brain before and after contrast (HCPCS:70553)
  • Mri scan of brain without contrast (HCPCS:70551)
  • Diagnostic mammography of 1 breast (HCPCS:77065)
  • Diagnostic mammography of both breasts (HCPCS:77066)
  • Complete ultrasound scan of abdomen (HCPCS:76700)
  • X-ray of hand, 2 views (HCPCS:73120)
  • Ultrasound scan of head and neck soft tissue (HCPCS:76536)
  • Limited ultrasound scan of 1 breast (HCPCS:76642)
  • Ct scan head or brain without contrast (HCPCS:70450)
  • Complete ultrasound scan behind abdominal cavity (HCPCS:76770)
  • Mri scan of upper spinal canal without contrast (HCPCS:72141)
  • Ct scan of abdomen and pelvis without contrast (HCPCS:74176)
  • Mri scan of leg joint without contrast (HCPCS:73721)
  • X-ray of lower and sacral spine, 2-3 views (HCPCS:72100)
  • Limited ultrasound scan of abdomen (HCPCS:76705)
  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • Mri scan of arm joint without contrast (HCPCS:73221)
  • X-ray of foot, 2 views (HCPCS:73620)
  • X-ray of hip, 2-3 views (HCPCS:73502)
  • Ultrasound scan of abdominal aorta (HCPCS:76706)
  • Ct scan of abdomen and pelvis before and after contrast (HCPCS:74178)
  • X-ray of knee, 3 views (HCPCS:73562)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Limited ultrasound scan of joint or other extremity structure lacking blood vessels (HCPCS:76882)
  • Low dose ct scan of chest for lung cancer screening (HCPCS:71271)
  • X-ray of knee, 1-2 views (HCPCS:73560)
  • Dxa bone density measurement of forearm, finger, hand, or foot (HCPCS:77081)
  • Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina (HCPCS:76830)
  • Mri scan of pelvis before and after contrast (HCPCS:72197)
  • X-ray of foot, minimum of 3 views (HCPCS:73630)
  • Complete ultrasound scan of pelvis (HCPCS:76856)
  • Ultrasound of both sides of head and neck blood flow (HCPCS:93880)
  • Mri scan of abdomen before and after contrast (HCPCS:74183)
  • X-ray of abdomen, 1 view (HCPCS:74018)
  • Mri scan of pelvis without contrast (HCPCS:72195)
  • Ct scan of lower spine without contrast (HCPCS:72131)
  • Ct scan of soft tissue of neck with contrast (HCPCS:70491)
  • Ct scan of abdomen with contrast (HCPCS:74160)
  • X-ray of knee, 4 or more views (HCPCS:73564)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • Mri scan of middle spinal canal without contrast (HCPCS:72146)

The enumeration date for this NPI number is 5/3/2006 and was last updated on 3/19/2024.

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
12085R0202XRadiologyDiagnostic RadiologyNORTH CAROLINAYes

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
1SL0083MEDICAIDSOUTH CAROLINA
201514OTHERNORTH CAROLINABCBS NC
3NPB300MEDICAIDSOUTH CAROLINA
4153718700OTHERNORTH CAROLINADOL
5P00315955OTHERMEDICARE RR
66901514MEDICAIDNORTH CAROLINA

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.