NPIMap

Organization Active NPI

Advanced Medical Imaging Center LLC

Doing business as Southwest Imaging Centers

  • Diagnostic Radiology Physician
  • Vancouver, WA
National Provider Identifier
1114008737
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ADVANCED MEDICAL IMAGING CENTER LLC
Doing business as
Southwest Imaging Centers
Practice address
16821 SE McGillivray Blvd
Vancouver, WA 98683-0499
Phone
(360) 883-0885
Fax
(360) 883-0071
NPI assigned
Oct 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Quentin Phillips II
Title
Administrator
Phone
(360) 883-0885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X WA Primary

Addresses

Primary practice location

16821 SE McGillivray Blvd
Vancouver, WA 98683-0499

Mailing address

16821 SE McGillivray Blvd
Vancouver, WA 98683-0499
Phone (360) 883-0885

Other identifiers 1

IdentifierTypeStateIssuer
7104359MedicaidWA

Other names 1

  • SOUTHWEST IMAGING CENTERS Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Peacehealth

    dba PeaceHealth Southwest Medical Center

    • General Acute Care Hospital
    • Vancouver, WA
    • NPI 1134178999

    Member Of

    NPD member

Locations

16821 SE McGillivray Blvd
Ste 114
Vancouver, WA 98683
Phone (360) 635-5352

Practitioners & affiliated clinicians

Practitioners 48

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.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114008737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16821 SE MCGILLIVRAY BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986830499",
            "telephone_number": "360-883-0885",
            "fax_number": "360-883-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16821 SE MCGILLIVRAY BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986830499",
            "telephone_number": "360-883-0885",
            "fax_number": "360-883-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "QUENTIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "360-883-0885",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7104359",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHWEST IMAGING CENTERS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.