NPIMap

Organization Active NPI

Arrowhead Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • Colton, CA
National Provider Identifier
1023113172
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ARROWHEAD RADIOLOGY MEDICAL GROUP INC
Practice address
400 N Pepper Ave
Colton, CA 92324-1801
Phone
(909) 580-1520
Fax
(909) 580-1561
NPI assigned
Sep 13, 2006
Last updated
Sep 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Fredrick L Orr, M.D.
Title
President
Phone
(909) 580-1580

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X CA
Diagnostic Radiology Physician 2085R0202X CA Primary
Vascular & Interventional Radiology Physician 2085R0204X CA
Diagnostic Ultrasound Physician 2085U0001X CA

Addresses

Primary practice location

400 N Pepper Ave
Colton, CA 92324-1801

Mailing address

PO Box 26060
Fresno, CA 93729-6060
Phone (559) 455-4000

Other identifiers 1

IdentifierTypeStateIssuer
GR0012310MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414000415 CA Part B Supplier - Clinic/Group Practice 5395739023 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
Practice locations: Banning, CA; Colton, CA; Santa Monica, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Arrowhead Radiology Medical Group Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1023113172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26060",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937296060",
            "telephone_number": "559-455-4000",
            "fax_number": "559-455-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1520",
            "fax_number": "909-580-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARROWHEAD RADIOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "ORR",
        "authorized_official_first_name": "FREDRICK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-580-1580",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0012310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.