Active NPI
Medical Imaging of Carlsbad PA
- Diagnostic Radiology Physician
- Carlsbad, NM
National Provider Identifier
1205917150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- MEDICAL IMAGING OF CARLSBAD PA
- Practice address
- 411 N Canyon
Carlsbad Medical Center
Carlsbad, NM 88220 - Phone
- (575) 887-0323
- Fax
- (575) 887-8018
- NPI assigned
- Oct 18, 2006
- 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
- Lachme T Sullesta
- Title
- Office Manager
- Phone
- (575) 887-0323
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
411 N Canyon
Carlsbad Medical Center
Carlsbad, NM 88220
Mailing address
411 N Canyon
Carlsbad, NM 88220
Phone (575) 887-0323
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50872 | Medicaid | NM |
National Provider Directory
National Provider DirectoryLocations
411 N Canyon St
Carlsbad, NM 88220
Phone (575) 887-0323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210896000000",
"number": "1205917150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 N CANYON",
"city": "CARLSBAD",
"state": "NM",
"postal_code": "88220",
"telephone_number": "575-887-0323",
"fax_number": "575-887-8018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 N CANYON",
"address_2": "CARLSBAD MEDICAL CENTER",
"city": "CARLSBAD",
"state": "NM",
"postal_code": "88220",
"telephone_number": "575-887-0323",
"fax_number": "575-887-8018"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL IMAGING OF CARLSBAD PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-18",
"last_updated": "2008-05-16",
"status": "A",
"authorized_official_last_name": "SULLESTA",
"authorized_official_first_name": "LACHME",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "575-887-0323"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "50872",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Carlsbad, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.