NPIMap

Organization Active NPI

Diagnostic Imaging of Southern Nevada

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1063410918
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2000048426 Issued in NV
Legal business name
DIAGNOSTIC IMAGING OF SOUTHERN NEVADA
Practice address
3560 E Flamingo Rd
Suite 100
Las Vegas, NV 89121-5044
Phone
(702) 433-6100
Fax
(702) 433-9576
NPI assigned
Jul 13, 2005
Last updated
Oct 16, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
Dr. Michael Allen Baron, M.D.NPI 1821096827
Title
Manager of General Partner
Phone
(702) 433-6100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2000048426 NV Primary

Addresses

Primary practice location

3560 E Flamingo Rd
Suite 100
Las Vegas, NV 89121-5044

Mailing address

3560 E Flamingo Rd
Suite 100
Las Vegas, NV 89121-5044
Phone (702) 433-6100

Other identifiers 1

IdentifierTypeStateIssuer
716409MedicaidAZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1063410918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 E FLAMINGO RD",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215044",
            "telephone_number": "702-433-6100",
            "fax_number": "702-433-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 E FLAMINGO RD",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215044",
            "telephone_number": "702-433-6100",
            "fax_number": "702-433-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC IMAGING OF SOUTHERN NEVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "BARON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "MANAGER OF GENERAL PARTNER",
        "authorized_official_telephone_number": "702-433-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "2000048426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "716409",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.