MARK S. TWEDT MD
NPI 1811293525
Radiology - Diagnostic Radiology in Richmond, VA

Q: What is Mark Twedt's NPI number?

The NPI number for Mark Twedt is 1811293525. It was assigned to this individual provider in the NPPES registry on January 28, 2011.

Q: What is Mark Twedt's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Mark Twedt was last updated on August 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 28, 2011PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

1250 E MARSHALL ST, DEPT. OF RADIOLOGY, RICHMOND, VA 23298(804) 828-6831(804) 628-1132 Get Directions Write a Review

NPPES record last updated: August 3, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Mark S. Twedt Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK S. TWEDT MD (NPI 1811293525) is an individual diagnostic radiology provider in Richmond, Virginia, licensed in Virginia (0101259401) and active in the NPI registry since January 2011. He is enrolled in Medicare PECOS, is affiliated with St Mary's Hospital, and is a graduate of Mercer University School Of Medicine (2011).

NPPES Registry Identity

NPI1811293525

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameMARK S. TWEDTCredential: MD

Location Address1250 E MARSHALL ST, DEPT. OF RADIOLOGYRichmond, VA 23298-5051

Mailing AddressPo Box 91734Richmond, VA 23291-1734 · (804) 358-6100 · Fax (804) 342-7619

Phone(804) 828-6831

Fax(804) 628-1132

Sole ProprietorNo

Medical School CMSMercer University School Of MedicineGraduated 2011

Enumeration DateJanuary 28, 2011

Last NPPES UpdateAugust 3, 2016

✔ NPI 1811293525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in VA · 0101259401

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

1250 E MARSHALL ST, Richmond, VA 23298

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mark S. Twedt Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID244475127

PECOS Enrollment IDI20170601000637

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 57

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of chest, 1 view 71045

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

1,008 services798 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

276 services257 patients

Ct scan of abdomen and pelvis with contrast 74177

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

243 services234 patients

3d radiographic procedure 76376

A 3D radiographic procedure is a non-invasive imaging test that helps doctors visualize the internal structures of your body in three dimensions. This advanced technology provides detailed images, aiding in accurate diagnosis and treatment planning. It involves exposure to minimal radiation.

178 services172 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

124 services121 patients

Ct scan of abdomen and pelvis without contrast 74176

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

121 services116 patients

Mri scan of leg joint without contrast 73721

An MRI scan of your leg joint is a non-invasive procedure that uses magnetic fields and radio waves to create detailed images of the structures within your leg. This helps doctors diagnose or monitor conditions without using contrast dye.

120 services117 patients

Ct scan of blood vessels of chest with contrast 71275

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

93 services93 patients

Mri scan of arm joint without contrast 73221

An MRI scan of the arm joint is a non-invasive imaging procedure that uses magnetic fields and radio waves to create detailed images of the structures within your arm joint. No contrast dye is used in this process. It helps to diagnose or monitor conditions like arthritis, injuries, or infections.

92 services89 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

83 services77 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

83 services83 patients

Ct scan head or brain without contrast 70450

A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.

79 services79 patients

Ct scan of chest with contrast 71260

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

79 services77 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

72 services71 patients

Ultrasound study of arm or leg veins with compression and maneuvers 93970

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

66 services64 patients

Ct scan of pelvis without contrast 72192

A CT scan of the pelvis without contrast is a non-invasive imaging test. It uses X-rays to create detailed pictures of your lower abdomen area. It helps in detecting issues like injuries, inflammation, or abnormal growths. It doesn't involve any dye injection.

63 services62 patients

Mri scan of leg joint without contrast 73721

63 services61 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

58 services49 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

58 services58 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

53 services53 patients

Mri scan of arm joint without contrast 73221

53 services51 patients

Limited ultrasound scan of abdomen 76705

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

50 services50 patients

Ct scan of leg without contrast 73700

A CT scan of the leg is a non-invasive imaging test that uses X-rays to capture detailed images of your leg's bones, muscles, and blood vessels. It doesn't use contrast dye and doesn't cause any pain. It helps in diagnosing injuries or diseases.

48 services46 patients

X-ray of chest, 2 views 71046

41 services41 patients

X-ray of pelvis, 1-2 views 72170

An X-ray of the pelvis, 1-2 views, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the lower part of your torso. These images help to detect any abnormalities or injuries in your hip bones and surrounding structures.

41 services41 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

39 services39 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

38 services35 patients

Mri scan of leg without contrast 73718

An MRI scan of the leg without contrast is a non-invasive imaging procedure. It uses a magnetic field and radio waves to create detailed images of the structures in your leg, such as bones, muscles, and blood vessels. No contrast dye is used.

35 services31 patients

X-ray of abdomen, 2 views 74019

An X-ray of the abdomen, 2 views, is a non-invasive imaging test. It uses a small amount of radiation to capture pictures of the structures inside your belly. The two views provide different angles, helping doctors see your organs clearly and detect any issues.

34 services32 patients

X-ray of abdomen, 1 view 74018

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

32 services31 patients

X-ray of thigh bone, minimum 2 views 73552

An X-ray of the thigh bone is a non-invasive imaging test. It involves passing a small amount of radiation through the thigh to produce images of the bone structure. At least two different angles are captured for a comprehensive view. This helps detect fractures, infections, or other abnormalities.

31 services28 patients

Low dose ct scan of chest for lung cancer screening 71271

A low-dose CT scan of the chest is a quick, painless procedure that uses a small amount of radiation to create detailed images of your lungs. It's a key tool for early detection of lung cancer, especially for those at high risk.

29 services29 patients

Ct scan of upper spine without contrast 72125

A CT scan of the upper spine without contrast is a non-invasive imaging test that uses X-rays to capture detailed images of your neck and upper back. It helps in identifying issues like fractures, tumors, or infections. No dye (contrast) is used in this scan.

29 services29 patients

X-ray of elbow, minimum of 3 views 73080

An elbow X-ray with a minimum of 3 views is a non-invasive imaging test. It helps visualize the bones of the elbow from different angles. This aids in diagnosing conditions like fractures or arthritis. The procedure is quick, painless, and usually takes around 15 minutes.

29 services29 patients

X-ray of lower leg, 2 views 73590

An X-ray of the lower leg, 2 views, is a quick, painless test that produces images of the bones in your lower leg. It helps to identify fractures, infections, or diseases. Two different angles are used to provide a comprehensive view of the leg's structure.

29 services27 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

28 services24 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

26 services22 patients

3d radiographic procedure 76376

26 services26 patients

X-ray of forearm, 2 views 73090

An X-ray of the forearm, 2 views, is a diagnostic procedure where two different pictures of your forearm are taken using a small amount of radiation. These images help doctors assess your bone health and identify any fractures, infections, or other abnormalities.

22 services20 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

22 services21 patients

Ct scan of arm without contrast 73200

A CT scan of the arm without contrast is a non-invasive imaging test. It uses X-ray technology to capture detailed images of your arm's structures. It doesn't involve any contrasting dye, hence, minimal preparation is required. It helps in diagnosing injuries or conditions affecting the arm.

22 services22 patients

Ct scan of arm without contrast 73200

22 services21 patients

Ct scan of leg without contrast 73700

22 services22 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

21 services20 patients

Mri scan of leg without contrast 73718

21 services19 patients

Mri scan of leg before and after contrast 73720

An MRI scan of the leg involves using a magnetic field and radio waves to create detailed images of the structures within your leg. Initially, images are taken without a contrast agent. Then, a contrast agent is injected into your body to enhance the images, highlighting certain areas for closer examination.

19 services16 patients

X-ray of abdomen, minimum of 3 views 74021

An X-ray of the abdomen with a minimum of 3 views is a non-invasive imaging test. It uses a small amount of radiation to produce images of the structures inside your abdomen. This helps in diagnosing conditions related to the stomach, liver, spleen, and kidneys. It's quick and painless.

18 services16 patients

X-ray of lower and sacral spine, 2-3 views 72100

17 services17 patients

X-ray of upper arm, minimum of 2 views 73060

An X-ray of the upper arm with a minimum of 2 views involves capturing images of your arm from different angles. This helps in assessing the bones and surrounding tissues for any abnormalities or injuries. It's a quick, painless procedure.

17 services16 patients

Ct scan of abdomen and pelvis before and after contrast 74178

A CT scan of your abdomen and pelvis with and without contrast helps visualize your internal organs better. Contrast is a special dye that improves the clarity of the images. It's taken orally or injected into your veins before the scan. The process is painless and quick.

17 services17 patients

X-ray series of abdomen with single x-ray of chest 74022

An X-ray series of the abdomen and a single X-ray of the chest are imaging tests. They help doctors view the structures within your abdomen and chest. These tests can detect issues like blockages, infections, or tumors. You'll be positioned carefully, and the machine captures images.

16 services16 patients

Ct scan of heart with evaluation of blood vessel calcium 75571

A CT scan of the heart with evaluation of blood vessel calcium is a non-invasive test that uses X-rays to create detailed images of your heart. It helps in detecting and measuring calcium-containing plaque in the arteries, which can indicate heart disease.

16 services16 patients

X-ray of upper spine, 2-3 views 72040

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

15 services15 patients

Ct scan of blood vessels of abdomen and pelvis with contrast 74174

A CT scan of the abdomen and pelvis with contrast is a medical imaging procedure. A special dye, called contrast, is used to make blood vessels more visible. The scan produces detailed images of your abdomen and pelvis, helping doctors to diagnose conditions or plan treatments.

15 services15 patients

Double contrast x-ray of esophagus 74221

A double contrast x-ray of the esophagus is a diagnostic procedure that uses a special type of x-ray and a contrast material to capture detailed images of your esophagus. This helps in identifying any abnormalities or issues.

13 services12 patients

Complete ultrasound scan of abdomen 76700

A complete ultrasound scan of the abdomen is a non-invasive imaging procedure. It uses sound waves to produce images of the organs in your abdomen, such as the liver, gallbladder, spleen, pancreas, and kidneys. It helps in diagnosing, monitoring, and planning treatments.

13 services13 patients

X-ray of upper spine, 4-5 views 72050

An X-ray of the upper spine with 4-5 views is a non-invasive imaging test. It uses radiation to capture detailed images of the bones and structures in your neck and upper back. This procedure helps identify issues like fractures, infections, or deformities.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Mary's Hospital

Acute Care Hospitals · Athens, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110006

Location1230 Baxter StreetAthens, GA 30606 · Clarke County

Emergency services Birthing friendly

Ty Cobb Regional Medical Center, LLC

Acute Care Hospitals · Lavonia, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110027

Location367 Clear Creek ParkwayLavonia, GA 30553 · Franklin County

Emergency services Birthing friendly

Piedmont Walton Hospital

Acute Care Hospitals · Monroe, GA

4/5 CMS rating

OwnershipProprietary

CMS Certification Number110046

Location2151 W Spring StreetMonroe, GA 30655 · Walton County

Emergency services Birthing friendly

Piedmont Athens Regional Medical Center

Acute Care Hospitals · Athens, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110074

Location1199 Prince AvenueAthens, GA 30606 · Clarke County

Birthing friendly

St. Mary's Good Samaritan Hospital

Critical Access Hospitals · Greensboro, GA

4/5 CMS rating

OwnershipProprietary

CMS Certification Number111329

Location5401 Lake Oconee ParkwayGreensboro, GA 30642 · Greene County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23298 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$70.08 typical visit price

range $18.07 – $138.91

Typical copayment $17.52 (range $4.51 – $34.72)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Reported Quality Measures

Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy

Percentage of final reports for all patients, regardless of age, undergoing bone scintigraphy that include physician documentation of correlation with existing relevant imaging studies (e.g., x-ray, MRI, CT, etc.) that were performed

88%25 patients

Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques

Percentage of final reports for patients aged 18 years and older undergoing CT with documentation that one or more of the following dose reduction techniques were used: - Automated exposure control - Adjustment of the mA and/or kV according to patient size -…

0%614 patients

Radiology: Reminder System for Screening Mammograms

Percentage of patients undergoing a screening mammogram whose information is entered into a reminder system with a target due date for the next mammogram

57%51 patients

Radiology: Stenosis Measurement in Carotid Imaging Reports

Percentage of final reports for carotid imaging studies (neck magnetic resonance angiography [MRA], neck computed tomography angiography [CTA], neck duplex ultrasound, carotid angiogram) performed that include direct or indirect reference to measurements of…

91%104 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEVIN YILMAZ MD

Student in an Organized Health Care Education/Training Program

1250 E MARSHALL ST
RICHMOND, VA 23298

Richmond City (804) 828-9783

MS. RENEE D SEAMAN NP

Nurse Practitioner (Family)

1250 E MARSHALL ST, GENERAL MEDICINE
RICHMOND, VA 23298

Richmond City (804) 828-3144

DR. AIMEE COLLINS MD

Internal Medicine

1250 E MARSHALL ST, INTERNAL MEDICINE
RICHMOND, VA 23298

Richmond City (804) 828-3144

MRS. MARY ELIZABETH O'BOYLE WILLIS FNP

Nurse Practitioner (Family)

1250 E MARSHALL ST, DEPARTMENT OF PEDIATRICS
RICHMOND, VA 23298

Richmond City (804) 628-0189

DR. AMY SAMANTHA MAY PAUL M.D.

Internal Medicine (Geriatric Medicine)

1250 E MARSHALL ST, DEPT. OF INTERNAL MEDICINE/GERIATRIC MEDICINE
RICHMOND, VA 23298

Richmond City (804) 254-3500

MRS. ERICA STOREY CLINE PA-C

Physician Assistant

1250 E MARSHALL ST, EMERGENCY MEDICINE
RICHMOND, VA 23298

Richmond City (804) 828-0996

CYNTHIA CHENAULT AGACNP

Nurse Practitioner (Acute Care)

1250 E MARSHALL ST
RICHMOND, VA 23298

Richmond City (804) 628-3646

DR. TAYLOR LATIA ROACH MD

Student in an Organized Health Care Education/Training Program

1250 E MARSHALL ST
RICHMOND, VA 23298

Richmond City (804) 628-7497

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Twedt's NPI number?

The NPI number for Mark Twedt is 1811293525. It was assigned to this individual provider in the NPPES registry on January 28, 2011.

Where is Mark Twedt located?

Mark Twedt practices at 1250 E Marshall St Dept. Of Radiology, Richmond, VA 23298. The listed phone number is (804) 828-6831.

What is Mark Twedt's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Mark Twedt enrolled in Medicare?

Yes. Mark Twedt is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Mark Twedt affiliated with any hospitals?

According to CMS data, Mark Twedt is affiliated with St Mary's Hospital, Ty Cobb Regional Medical Center, LLC, Piedmont Walton Hospital, Piedmont Athens Regional Medical Center and St. Mary's Good Samaritan Hospital.

When was this NPI record last updated?

The NPPES record for Mark Twedt was last updated on August 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.