Provider Demographics
| NPI: | 1093741464 |
|---|---|
| Name: | ADVANCED DIAGNOSTIC IMAGING, PC |
| Entity Type: | Organization |
| Organization Name: | ADVANCED DIAGNOSTIC IMAGING, PC |
| Other - Org Name: | ADVANCEDHEALTH |
| Other - Org Type: | Doing Business As |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | CHAD |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | CALENDINE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 615-854-3409 |
| Mailing Address - Street 1: | 3024 BUSINESS PARK CIR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | GOODLETTSVILLE |
| Mailing Address - State: | TN |
| Mailing Address - Zip Code: | 37072-3132 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 615-239-2018 |
| Mailing Address - Fax: | 615-851-2018 |
| Practice Address - Street 1: | 3024 BUSINESS PARK CIR |
| Practice Address - Street 2: | |
| Practice Address - City: | GOODLETTSVILLE |
| Practice Address - State: | TN |
| Practice Address - Zip Code: | 37072-3132 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 615-239-2061 |
| Practice Address - Fax: | 615-296-9949 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-06-25 |
| Last Update Date: | 2021-05-27 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
| No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
| No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 208VP0014X | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | Group - Multi-Specialty |
| No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Group - Multi-Specialty | |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | Group - Multi-Specialty | |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TN | 65927428 | Other | KY MEDICAID |
| TN | 3372986 | Medicaid | |
| TN | 2006756 | Other | BCBS |
| TN | 3372986 | Medicare PIN |
