Nahuel Image Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NAHUEL IMAGE CENTER

Doing business as

NIC

Practice address

1700 N State St
Suite 16
Provo, UT 84604-1011

Phone

(801) 822-5644

Fax

(888) 258-9831

NPI assigned

Nov 6, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Mariano Reginato

Title

President

Phone

(970) 250-6170

Specialties & licenses 1

Addresses

Other names 1

• NIC Doing business as

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1205232923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N STATE ST",
            "address_2": "SUITE 16",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041011",
            "telephone_number": "801-822-5644",
            "fax_number": "888-258-9831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N STATE ST",
            "address_2": "SUITE 16",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041011",
            "telephone_number": "801-822-5644",
            "fax_number": "888-258-9831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAHUEL IMAGE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "REGINATO",
        "authorized_official_first_name": "MARIANO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-250-6170",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas E Myers, MD
• James C Nackos, MPT
• Tina Nackos, CNM
• Brittany Naef
• Chanel Christine Nagaishi, MSWI
• Sydni Pualeilani Kiyoko Nakamoto
• Jason Jon Nakken, D.O.
• Kimbrie Nally
• Brad Steven Nance, M.D.
• Richard Jackson Nance Jr., LCSW

• Clinic/Center in Provo, UT
• Providers in Provo, UT by specialty
• Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.