Active NPI
Twin Falls Imaging & Diagnostic Center LLC
- Clinic/Center
- Twin Falls, ID
National Provider Identifier
1124185053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- TWIN FALLS IMAGING & DIAGNOSTIC CENTER LLC
- Practice address
- 562 Shoup Ave W
Twin Falls, ID 83301-5029 - Phone
- (208) 732-1205
- Fax
- (208) 736-2413
- NPI assigned
- Jan 2, 2007
- 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
- Frederick L Surbaugh, M.D.
- Title
- Owner
- Phone
- (208) 732-1205
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
562 Shoup Ave W
Twin Falls, ID 83301-5029
Mailing address
562 Shoup Ave W
Twin Falls, ID 83301-5029
Phone (208) 732-1205
National Provider Directory
National Provider DirectoryLocations
562 Shoup Ave W
Twin Falls, ID 83301
Phone (208) 734-0407
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Body Imaging Physician
- Burley, ID
- NPI 1609829613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214784000000",
"number": "1124185053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "562 SHOUP AVE W",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015029",
"telephone_number": "208-732-1205",
"fax_number": "208-736-2413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "562 SHOUP AVE W",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015029",
"telephone_number": "208-732-1205",
"fax_number": "208-736-2413"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TWIN FALLS IMAGING & DIAGNOSTIC CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-02",
"last_updated": "2008-06-30",
"status": "A",
"authorized_official_last_name": "SURBAUGH",
"authorized_official_first_name": "FREDERICK",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "208-732-1205",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Twin Falls, ID
- Twin Falls County
- Twin Falls Dental Group PLLC
- Twin Falls Dental PLLC
- Twin Falls Dermatology & Aesthetics
- Twin Falls Imaging & Diagnostic Center LLC
- Twin Falls Imaging and Diagnostic Center
- Twin Falls Internal Medicine PLLC
- Twin Falls Kids Dental LLC
- Twin Falls of Cascadia, LLC
- Twin Falls Orthopedics LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.