Active NPI
Parkway Imaging Center LLC
- Physiological Laboratory
- Henderson, NV
National Provider Identifier
1083679526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physiological Laboratory
- Legal business name
- PARKWAY IMAGING CENTER LLC
- Practice address
- 100 N Green Valley Pkwy
Ste 130
Henderson, NV 89074-6391 - Phone
- (702) 990-7419
- Fax
- (702) 990-7418
- NPI assigned
- Apr 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Brian G Drazba
- Title
- Senior V.P. & Chief Accounting Ofcr
- Phone
- (949) 282-6000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physiological Laboratory | 293D00000X | Primary |
Addresses
Primary practice location
100 N Green Valley Pkwy
Ste 130
Henderson, NV 89074-6391
Mailing address
File 57174
Los Angeles, CA 90074-7174
Phone (949) 282-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002702027 | Medicaid | NV |
Other names 1
- INSIGHT IMAGING - PARKWAY CENTER
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 29D2039397 | Pueblo Medical Imaging-Pkwy | Certificate of waiver | Apr 8, 2028 |
| 29D2262876 | Las Vegas Injury Pain Center | Certificate of waiver | Jun 19, 2028 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1209600000000",
"number": "1083679526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FILE 57174",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900747174",
"telephone_number": "949-282-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N GREEN VALLEY PKWY",
"address_2": "STE 130",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890746391",
"telephone_number": "702-990-7419",
"fax_number": "702-990-7418"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PARKWAY IMAGING CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-18",
"last_updated": "2008-05-01",
"status": "A",
"authorized_official_last_name": "DRAZBA",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "SENIOR V.P. & CHIEF ACCOUNTING OFCR",
"authorized_official_telephone_number": "949-282-6000",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "293D00000X",
"taxonomy_group": "",
"desc": "Physiological Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002702027",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "INSIGHT IMAGING - PARKWAY CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.