GREAT PLAINS RADIOLOGY LLC NPI 1780707877

NPI Information

  • NPI: 1780707877
  • Provider Name: GREAT PLAINS RADIOLOGY LLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Address: 12639 OLD TESSON RD
    SUITE 115
    SAINT LOUIS, MO
    ZIP 63128
  • Phone: (314) 842-8655

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NPI Details

GREAT PLAINS RADIOLOGY LLC is a diagnostic radiology radiology in Saint Louis, MO. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. GREAT PLAINS RADIOLOGY LLC NPI is 1780707877. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12639 OLD TESSON RD
SUITE 115
SAINT LOUIS, MO
ZIP 63128-786
Phone: (314) 842-8655
Fax: (314) 842-2972

The provider's authorized official is Edward Rene Habert .
The authorized official title is Director and has the following contact phone number (314) 822-0690.

The enumeration date for this NPI number is 4/6/2007 and was last updated on 8/22/2020.

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 RadiologyYes

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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