NPIMap

Organization Active NPI

Professional Portable Radiologic Services Inc.

Doing business as Dynamic Mobile Imaging

  • Physiological Laboratory
  • Ormond Beach, FL
National Provider Identifier
1174228308
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
PROFESSIONAL PORTABLE RADIOLOGIC SERVICES INC.
Doing business as
Dynamic Mobile Imaging
Practice address
1400 Hand Ave Ste a
Ormond Beach, FL 32174-8195
Phone
(303) 500-1518
NPI assigned
Apr 5, 2023
Last updated
Jul 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
William Kramer
Title
Chief Legal Officer
Phone
(215) 813-5940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X NU Primary

Addresses

Primary practice location

1400 Hand Ave Ste a
Ormond Beach, FL 32174-8195

Mailing address

3825 N Lafayette St
Denver, CO 80205-3316
Phone (303) 500-1518

Other names 1

  • Dynamic Mobile Imaging Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Professional Portable Radiologic Services Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1174228308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 N LAFAYETTE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802053316",
            "telephone_number": "303-500-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HAND AVE STE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748195",
            "telephone_number": "303-500-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PORTABLE RADIOLOGIC SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-05",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "KRAMER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "215-813-5940"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Mobile Imaging",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dynamic Mobile Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; 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.