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  7. NPI Record 1760897797

DIAGNOSTIC RADIOLOGY VEINS PC
Complete NPI Record 1760897797
Radiology - Vascular & Interventional Radiology in Dakota Dunes, SD

NPI Status: Active since June 28, 2014

Contact Information

345 W STEAMBOAT DR STE 401
DAKOTA DUNES, SD
ZIP 57049
Phone: (308) 647-6444
Fax: (866) 902-2445

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider Business Mailing Address Fax Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Title or Position
  24. Authorized Official Telephone Number
  25. Healthcare Provider Taxonomy Code 1
  26. Healthcare Provider Primary Taxonomy Switch 1
  27. Healthcare Provider Taxonomy Code 2
  28. Healthcare Provider Primary Taxonomy Switch 2
  29. Is Organization Subpart
  30. Parent Organization LBN
  31. Parent Organization TIN
  32. Authorized Official Credential Text
  33. Healthcare Provider Taxonomy Group 1
  34. Healthcare Provider Taxonomy Group 2
  35. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1760897797. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1760897797
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 14301 FNB PKWY STE 100
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Provider Business Mailing Address City Name: OMAHA
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NE
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 681547200
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 4024931212
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 8889721672
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 345 W STEAMBOAT DR STE 401
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: DAKOTA DUNES
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: SD
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 570495287
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3086476444
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 8669022445
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/28/2014
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 7/8/2021
The date that a record was last updated or changed.
Authorized Official Last Name: FORBES
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: ROBERT
The first name of the authorized official.
Authorized Official Title or Position: MD/PRESIDENT
The title or position of the authorized official.
Authorized Official Telephone Number: 4024931212
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 2085R0202X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 2085R0204X
Healthcare Provider Primary Taxonomy Switch 2: Y
Is Organization Subpart: Y
Parent Organization LBN: DIAGNOSTIC RADIOLOGY PC
Parent Organization TIN: UNAVAIL
Authorized Official Credential Text: MD
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP
NPI Certification Date: 7/8/2021