JACKSONVILLE DIAGNOSTIC IMAGING LLC NPI 1104874387

NPI Information

  • NPI: 1104874387
  • Provider Name: JACKSONVILLE DIAGNOSTIC IMAGING LLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Doing Business As: COASTAL DIAGNOSTIC IMAGING
  • Address: 3606 HENDERSON DR
    JACKSONVILLE, NC
    ZIP 28546
  • Phone: (910) 937-7226

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NPI Details

JACKSONVILLE DIAGNOSTIC IMAGING LLC is a diagnostic radiology radiology in Jacksonville, NC. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. JACKSONVILLE DIAGNOSTIC IMAGING LLC NPI is 1104874387. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Coastal Diagnostic Imaging.

The provider's business location address is:

3606 HENDERSON DR
JACKSONVILLE, NC
ZIP 28546-217
Phone: (910) 937-7226
Fax: (910) 937-0064

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 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.

  • Injection, gadobutrol, 0.1 ml (HCPCS:A9585)
  • Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml (HCPCS:Q9967)
  • Mri scan of lower spinal canal without contrast (HCPCS:72148)
  • Mri scan of upper spinal canal without contrast (HCPCS:72141)
  • Mri scan of arm joint without contrast (HCPCS:73221)
  • Mri scan of leg joint without contrast (HCPCS:73721)
  • Mri scan of brain before and after contrast (HCPCS:70553)
  • X-ray of lower and sacral spine, minimum of 4 views (HCPCS:72110)
  • Mri scan of brain without contrast (HCPCS:70551)
  • Mri scan of middle spinal canal without contrast (HCPCS:72146)
  • Mri scan of lower spinal canal before and after contrast (HCPCS:72158)
  • Ct scan of abdomen and pelvis with contrast (HCPCS:74177)
  • Complete ultrasound scan behind abdominal cavity (HCPCS:76770)
  • Ct scan of abdomen and pelvis without contrast (HCPCS:74176)
  • Ct scan of chest without contrast (HCPCS:71250)
  • X-ray of lower and sacral spine, 2-3 views (HCPCS:72100)
  • Ct scan of abdomen and pelvis before and after contrast (HCPCS:74178)
  • Ct scan of lower spine without contrast (HCPCS:72131)
  • X-ray of upper spine, 2-3 views (HCPCS:72040)
  • Limited ultrasound scan of abdomen (HCPCS:76705)
  • Ct scan head or brain without contrast (HCPCS:70450)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Ct scan of chest with contrast (HCPCS:71260)
  • Complete ultrasound scan of abdomen (HCPCS:76700)
  • Ultrasound of both sides of head and neck blood flow (HCPCS:93880)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Ct scan of leg without contrast (HCPCS:73700)
  • Mri scan of upper spinal canal before and after contrast (HCPCS:72156)
  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • X-ray of upper spine, 4-5 views (HCPCS:72050)
  • Ultrasound study of arm and leg arteries (HCPCS:93922)
  • X-ray of hip, 2-3 views (HCPCS:73502)
  • X-ray of knee, 1-2 views (HCPCS:73560)
  • X-ray lower and sacral spine, minimum of 6 views (HCPCS:72114)
  • X-ray lower and sacral spine, 2-3 views bending views (HCPCS:72120)
  • Mri scan of abdomen before and after contrast (HCPCS:74183)
  • Ultrasound scan of head and neck soft tissue (HCPCS:76536)
  • Ct scan of face without contrast (HCPCS:70486)
  • X-ray of knee, 3 views (HCPCS:73562)
  • Ct scan of upper spine without contrast (HCPCS:72125)
  • Ultrasound of leg arteries or artery grafts (HCPCS:93925)
  • X-ray of middle spine, 3 views (HCPCS:72072)
  • Ct scan of soft tissue of neck with contrast (HCPCS:70491)
  • Mri scan of leg without contrast (HCPCS:73718)
  • X-ray of both hips, 3-4 views (HCPCS:73522)
  • Mri scan of blood vessels of head without contrast (HCPCS:70544)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • Ct scan of arm without contrast (HCPCS:73200)
  • X-ray of foot, minimum of 3 views (HCPCS:73630)
  • Ct scan of abdomen before and after contrast (HCPCS:74170)
  • Mri scan of middle spinal canal before and after contrast (HCPCS:72157)

The enumeration date for this NPI number is 5/4/2006 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
189014UNMEDICAIDNORTH CAROLINA
2014UNOTHERNORTH CAROLINABCBS NC
3101136600OTHERNORTH CAROLINADOL
4P00107621OTHERNORTH CAROLINAMEDICARE RAILROAD

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: 3/30/2025

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