EXECUTIVE IMAGE INC
NPI 1588759849
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Winston Salem, NC

NPI Status: Active since October 04, 2006

Contact Information

7820 N POINT BLVD
SUITE 101
WINSTON SALEM, NC
ZIP 27106
Phone: (336) 245-0647
Fax: (336) 245-0649

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About EXECUTIVE IMAGE INC

This page provides the complete NPI Profile along with additional information for Executive Image Inc, a provider established in Winston Salem, North Carolina operating as a Portable X-ray And/or Other Portable Diagnostic Imaging Supplier. The healthcare provider is registered in the NPI registry with number 1588759849 assigned on October 2006. The practitioner's primary taxonomy code is 335V00000X with license number 600495328 (NC). The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Ms. Diana Goolsby (Owner)

NPI
1588759849
Provider Name
EXECUTIVE IMAGE INC
Entity Type
Organization
Location Address
7820 N POINT BLVD SUITE 101 WINSTON SALEM, NC 27106
Location Phone
(336) 245-0647
Location Fax
(336) 245-0649
Mailing Address
7820 N POINT BLVD SUITE 101 WINSTON SALEM, NC 27106
Mailing Phone
(336) 245-0647
Mailing Fax
(336) 245-0649
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-04-2006
Last Update Date
01-15-2015
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

Taxonomy Code
335V00000X
Type
Suppliers
License No.
600495328
License State
NC
Taxonomy Description
A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. DIANA GOOLSBY

Authorized Official Title
OWNER
Authorized Official Phone
(336) 918-6328

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
3409805MEDICAID (05)NC 
2530321MEDICARE ID-TYPE UNSPECIFIED (04)NCMEDICARE
=========OTHER (01)NCBCBS
P00245445OTHER (01)NCMEDICARE RAILROAD

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1588759849
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
251681451888
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 1 + 6 + 8 + 1 + 4 + 5 + 1 + 8 + 8 + 8 + 24 = 81
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
90 - 81 = 99

The NPI number 1588759849 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1134350622QUALITY MOBILE X-RAY, INC
Organization
Physiological Laboratory7820 N POINT BLVD SUITE 101
WINSTON SALEM, NC 27106
(336) 245-0647
1407950199MOBILE VISIONS INS
Organization
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier7820 N POINT BLVD SUITE 101
WINSTON SALEM, NC 27106
(336) 245-0647

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1588759849, enumerated in the NPI registry as an "organization" on October 04, 2006

The provider is located at 7820 N Point Blvd Suite 101 Winston Salem, Nc 27106 and the phone number is (336) 245-0647

This medical organization specializes in Portable X-ray and/or Other Portable Diagnostic Imaging Supplier with taxonomy code 335V00000X

The provider might be accepting Accepts: Medicare, Medicaid, Blue Cross Blue Shield and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on October 04, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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