Provider Demographics
NPI:1356418156
Name:MEDICAL PLAZA IMAGING ASSOCIATES, LLC
Entity type:Organization
Organization Name:MEDICAL PLAZA IMAGING ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:M
Authorized Official - Last Name:NACHTIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-932-3318
Mailing Address - Street 1:4321 WASHINGTON ST
Mailing Address - Street 2:STE. 1400
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-5961
Mailing Address - Country:US
Mailing Address - Phone:816-561-5858
Mailing Address - Fax:816-561-3740
Practice Address - Street 1:4321 WASHINGTON ST
Practice Address - Street 2:STE. 1400
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5961
Practice Address - Country:US
Practice Address - Phone:816-502-8782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No207RM1200XAllopathic & Osteopathic PhysiciansInternal MedicineMagnetic Resonance Imaging (MRI)Group - Single Specialty
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & TherapyGroup - Single Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100216390AMedicaid
MO506786003Medicaid
MOD080000Medicare PIN
KS100216390AMedicaid