OrganizationActive
Northside Imaging LLC
NPI 1063402279 · Diagnostic Radiology Physician · St Petersburg, FL
Provider details
- NPI number
- 1063402279
- Entity type
- Organization
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lavelle Hardin, Credentialing Coordinator(615) 344-8203
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6006 49th St N
Ste 140
St Petersburg, FL 33709-2148
Phone: (727) 528-5900
Fax: (727) 528-5911
Street-level locationGet directions
Mailing address
6006 49th St N
St Petersburg, FL 33709-2148
Other names (DBA / former)
- Doing business as
- Northside Imaging Center
Registry dates
- Enumerated
- 2005-10-27
- Last updated
- 2007-08-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.