Evolved Diagnostic Imaging PC

Primary specialty

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

Legal business name

EVOLVED DIAGNOSTIC IMAGING PC

Practice address

500 Capitol Mall Ste 2350
Sacramento, CA 95814-4760

Phone

(916) 414-8640

NPI assigned

Oct 25, 2021

Last updated

Oct 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jade Franks

Title

Revenue Manager

Phone

(916) 414-8640

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1073277125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CAPITOL MALL STE 2350",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958144760",
            "telephone_number": "916-414-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CAPITOL MALL STE 2350",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958144760",
            "telephone_number": "916-414-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVED DIAGNOSTIC IMAGING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "FRANKS",
        "authorized_official_first_name": "JADE",
        "authorized_official_title_or_position": "REVENUE MANAGER",
        "authorized_official_telephone_number": "916-414-8640"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mariah Ewell
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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.