OPEN AND WIDE MRI LLC NPI 1558346148

NPI Information

  • NPI: 1558346148
  • Provider Name: OPEN AND WIDE MRI, LLC
  • Classification: Radiologic Technologist - 2471M1202X
  • Specialization: Magnetic Resonance Imaging
  • Entity Type: Organization
  • Address: 3050 WINDSOR CT
    ELKHART, IN
    ZIP 46514
  • Phone: (574) 266-9222

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NPI Details

OPEN AND WIDE MRI, LLC is a magnetic resonance imaging radiologic technologist in Elkhart, IN. The provider is a radiologic technologist who specializes in magnetic resonance imaging (MRI) and is appropriately educated and trained, consistent with nationally recognized standards, state statute, and facility policy in performance of MRIs, exam techniques, equipment protocols, radiation safety, and patient care. OPEN AND WIDE MRI, LLC NPI is 1558346148. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3050 WINDSOR CT
ELKHART, IN
ZIP 46514-555
Phone: (574) 266-9222
Fax: (574) 266-9333

The provider's authorized official is Gardner Bartrom .
The authorized official title is President and has the following contact phone number (765) 228-4660.

The enumeration date for this NPI number is 12/7/2005 and was last updated on 1/8/2024.

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
12471M1202XRadiologic TechnologistMagnetic Resonance Imaging20590INDIANAYes

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
11604490821MEDICAIDMICHIGAN
2000000275391OTHERINDIANABCBS
314506OTHERPHP
4200415560AMEDICAIDINDIANA

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

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