Integra Imaging PS - Mt

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

INTEGRA IMAGING PS - MT

Practice address

2419 Mullan Rd
D
Missoula, MT 59808-1856

Phone

(509) 747-4455

NPI assigned

Sep 8, 2016

Organization subpart

Yes

Parent organization

INTEGRA IMAGING PSAs reported in NPPES

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

Authorized official

Name

Sarah Russell

Title

Coo

Phone

(509) 747-4455

Specialties & licenses 1

Addresses

Tax ID family

Inland Imaging PS2 organizations share this tax ID, including this one

Part of

Inland Imaging PS

Other organizations with this tax ID 1

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

• Integra Imaging PS

  • Diagnostic Radiology Physician
  • Spokane, WA
  • NPI 1609282763
  NPD tax ID

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1053868992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S STEVENS ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042654",
            "telephone_number": "509-747-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 MULLAN RD",
            "address_2": "D",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081856",
            "telephone_number": "509-747-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRA IMAGING PS - MT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRA IMAGING PS",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "509-747-4455"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Diagnostic Radiology Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.