Provider Demographics
NPI:1487626073
Name:TOPEKA IMAGING, LLC
Entity Type:Organization
Organization Name:TOPEKA IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEGENNARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-853-8667
Mailing Address - Street 1:5648 SW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2443
Mailing Address - Country:US
Mailing Address - Phone:785-228-3800
Mailing Address - Fax:785-228-3981
Practice Address - Street 1:5648 SW 29TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2443
Practice Address - Country:US
Practice Address - Phone:785-228-3800
Practice Address - Fax:785-228-3981
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIPELINE HEALTHCARE HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-07
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100376900AMedicaid
KS470000865OtherRAILROAD MEDICARE
KS110566OtherBLUE CROSS BLUE SHIELD
KS110566Medicare ID - Type Unspecified