Provider Demographics
NPI:1487700142
Name:MRI OF AMERICA, LLC
Entity type:Organization
Organization Name:MRI OF AMERICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CONGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-649-9688
Mailing Address - Street 1:6726 S. REVERE PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3962
Mailing Address - Country:US
Mailing Address - Phone:303-649-9688
Mailing Address - Fax:303-649-9689
Practice Address - Street 1:6726 S. REVERE PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3962
Practice Address - Country:US
Practice Address - Phone:303-649-9688
Practice Address - Fax:303-649-9689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO64235271Medicaid
COC506868Medicare PIN
C506868Medicare PIN