Advantage Mobile Diagnostic Imaging LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

ADVANTAGE MOBILE DIAGNOSTIC IMAGING LLC

Practice address

11212 Campo del Sol Ave NE
Albuquerque, NM 87123-1264

Phone

(505) 280-1283

NPI assigned

Sep 12, 2022

Organization subpart

No

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

Authorized official

Name

Charles Gilbert Montoya, RADIOGRAPHIC TECHNOL

Title

Owner

Phone

(505) 280-1283

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1023730637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11212 CAMPO DEL SOL AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871231264",
            "telephone_number": "505-280-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11212 CAMPO DEL SOL AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871231264",
            "telephone_number": "505-280-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE MOBILE DIAGNOSTIC IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "MONTOYA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "GILBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-280-1283",
        "authorized_official_credential": "RADIOGRAPHIC TECHNOL"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.