All-Stat Portable Mo LLC

Primary specialty

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

Legal business name

ALL-STAT PORTABLE MO LLC

Practice address

702 W Pine St
Poplar Bluff, MO 63901-5045

Phone

(224) 337-1000

NPI assigned

Dec 3, 2025

Last updated

Mar 9, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

ALL-STAT PORTABLE LLCAs reported in NPPES

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

Authorized official

Name

Etai Sooliman

Title

Ceo

Phone

(227) 337-1000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073476461. Details of each certification follow.

• CCN 26X0009841 Portable X-ray supplier · Active · Name & address match · Details

Portable X-ray supplier certification: CCN 26X0009841

Legal name

ALL-STAT PORTABLE MO LLC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Sep 2, 2015

Last certification

Mar 21, 2024

Ownership / control type

Individual

Facility address

702 W Pine St
Poplar Bluff, MO 63901

Tax ID family

All-Stat Portable Mo LLC2 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.

• All-Stat Portable Mo LLC

  • Mobile Radiology Clinic/Center
  • Poplar Bluff, MO
  • NPI 1144183534
  NPD tax ID

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1073476461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8235 CHRISTIANA AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762910",
            "telephone_number": "224-337-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W PINE ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015045",
            "telephone_number": "224-337-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL-STAT PORTABLE MO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALL-STAT PORTABLE LLC",
        "enumeration_date": "2025-12-03",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "SOOLIMAN",
        "authorized_official_first_name": "ETAI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "227-337-1000"
    },
    "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": []
}

• Donna D Akers, FNP-C
• Tirso J Aldana, M.D.
• Kristen M Alexander-Frey, DMD
• Mohanad Ali Alfaqih, M.D
• Ali Ahsan Ali, MD
• All-Stat Portable Mo LLC
• Lindsay Allbritton, FNP
• Allen Chiropractic Wellness Center
• Cheryl Cornell Allen, NP
• Larry Todd Allen, L.P.C.

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.