NPIMap

Organization Active NPI

Ambulatory Neurological Services, LLC

  • Electroneurodiagnostic Specialist/Technologist
  • West Jordan, UT
National Provider Identifier
1154631505
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
Legal business name
AMBULATORY NEUROLOGICAL SERVICES, LLC
Practice address
8541 S Redwood Rd
Ste A1
West Jordan, UT 84088-9327
Phone
(801) 999-4857
Fax
(866) 273-5772
NPI assigned
Oct 19, 2010
Organization subpart
Yes
Parent organization
AMBULATORY NEUROLOGICAL SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Authorized official

Name
Mr. Miguel Iribarren
Title
President
Phone
(847) 340-9726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246ZE0600X Primary

Addresses

Primary practice location

8541 S Redwood Rd
Ste A1
West Jordan, UT 84088-9327

Mailing address

PO Box 28669
San Diego, CA 92198-0669
Phone (888) 447-5904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110930000199 UT Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032262266 Practice locations: West Jordan, UT

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ambualtory Neurological LLC3 organizations share this tax ID, including this one
Part of
Ambualtory Neurological LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1154631505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28669",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921980669",
            "telephone_number": "888-447-5904",
            "fax_number": "866-273-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8541 S REDWOOD RD",
            "address_2": "STE A1",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889327",
            "telephone_number": "801-999-4857",
            "fax_number": "866-273-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY NEUROLOGICAL SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMBULATORY NEUROLOGICAL SERVICES, LLC",
        "enumeration_date": "2010-10-19",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "IRIBARREN",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-340-9726",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.