Active NPI
Smi Imaging, LLC
- Diagnostic Radiology Physician
- Mesa, AZ
National Provider Identifier
1013268705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- SMI IMAGING, LLC
- Practice address
- 1111 S Dobson Rd
Suite 105
Mesa, AZ 85202-3902 - Phone
- (480) 964-4995
- Fax
- (480) 964-7209
- NPI assigned
- Sep 21, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Howard J Simon, M.D.
- Title
- President
- Phone
- (480) 264-2400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
1111 S Dobson Rd
Suite 105
Mesa, AZ 85202-3902
Mailing address
PO Box 7368
Orange, CA 92863-7368
Phone (714) 571-5000
Other names 1
- SimonMed Imaging Mesa Desert Campus
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D1077644 | Smi Imaging LLC Dba Simonmed Imaging | Certificate of waiver | Apr 17, 2028 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348185600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1348185600000",
"number": "1013268705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7368",
"city": "ORANGE",
"state": "CA",
"postal_code": "928637368",
"telephone_number": "714-571-5000",
"fax_number": "714-571-5055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 S DOBSON RD",
"address_2": "SUITE 105",
"city": "MESA",
"state": "AZ",
"postal_code": "852023902",
"telephone_number": "480-964-4995",
"fax_number": "480-964-7209"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SMI IMAGING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-09-21",
"last_updated": "2012-09-21",
"status": "A",
"authorized_official_last_name": "SIMON",
"authorized_official_first_name": "HOWARD",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "480-264-2400",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SimonMed Imaging Mesa Desert Campus",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.