Active NPI
Smi Imaging LLC
Doing business as Simonmed Imaging
- Diagnostic Radiology Physician
- Prescott, AZ
National Provider Identifier
1124624093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- SMI IMAGING LLC
- Doing business as
- Simonmed Imaging
- Practice address
- 790 Gail Gardner Way
Prescott, AZ 86305-2337 - Phone
- (928) 776-2660
- NPI assigned
- Dec 7, 2020
- 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
- Howard John Simon, MD
- Title
- Ceo
- Phone
- (480) 478-6545
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
790 Gail Gardner Way
Prescott, AZ 86305-2337
Mailing address
6900 E Camelback Rd Ste 700
Scottsdale, AZ 85251-2400
Phone (480) 306-6949
Other names 1
- SIMONMED IMAGING
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 |
|---|---|---|---|
| 03D2125471 | Smi Imaging LLC Dba Simonmed Imaging | Certificate of waiver | Feb 6, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Simonmed Imaging
Organizations with this tax ID in the same state 16
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607299200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1607299200000",
"number": "1124624093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6900 E CAMELBACK RD STE 700",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852512400",
"telephone_number": "480-306-6949",
"fax_number": "602-302-5706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 GAIL GARDNER WAY",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863052337",
"telephone_number": "928-776-2660"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SMI IMAGING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-07",
"last_updated": "2020-12-07",
"certification_date": "2020-12-07",
"status": "A",
"authorized_official_last_name": "SIMON",
"authorized_official_first_name": "HOWARD",
"authorized_official_middle_name": "JOHN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "480-478-6545",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SIMONMED IMAGING",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.