Ft. Jesse Imaging Center LLC
NPI 1104333491ActiveOrganization· Radiology, Diagnostic Radiology· Normal, IL
Radiology, Diagnostic Radiology in Normal, Illinois, registered in NPPES in January 2018. The authorized official on file is Amy Stout, President/Ceo.
Overview
| NPI | 1104333491 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 8, 2018 |
| Last updated in NPPES | Oct 21, 2024 |
| Certified by provider | Oct 21, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Radiology, Diagnostic Radiology Primary | 2085R0202X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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