Quality Medical Imaging of Oklahoma, Inc.

Primary specialty

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

Legal business name

QUALITY MEDICAL IMAGING OF OKLAHOMA, INC.

Practice address

201 Shady Creek Rd Ste 115
Durant, OK 74701-2412

Phone

(580) 634-7600

NPI assigned

Jul 30, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Roger C Faselt

Title

President

Phone

(702) 839-1133

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Portable X-ray supplier certification: CCN 37X0009836

Legal name

QUALITY MEDICAL IMAGING OF OKLAHOMA, INC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

May 3, 2021

Last certification

May 3, 2021

Ownership / control type

Corporation

Facility address

201 Shady Creek Rd, Ste 115
Durant, OK 74701

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1124637574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 PROFESSIONAL CT STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280835",
            "telephone_number": "702-839-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SHADY CREEK RD STE 115",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012412",
            "telephone_number": "580-634-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY MEDICAL IMAGING OF OKLAHOMA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "FASELT",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-839-1133",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "apl.qrad.com",
            "affiliation": "N",
            "endpointDescription": "HL7",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Las Vegas",
            "address_1": "201 Shady Creed Rd",
            "address_2": "Suite 113",
            "city": "Durant",
            "state": "OK",
            "country_code": "US",
            "postal_code": "74701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Autumn Hope Purcell
• Madison Lee Purdom, DO
• Purify Dental of Durant PLLC
• Abinayaa Purushothaman Ravichandran, MD
• Iman Qaiser, MD
• Quality Medical Imaging of Oklahoma, Inc.
• R. Burton Ludrick, D.D.S., PC
• Carla Beth Rabon, MA
• David Michael Rackley, PMHNP-BC
• Ashley Ralston, OTR

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Durant, OK
• Providers in Durant, OK by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.