Organization Active NPI

Medical Imaging of Carlsbad PA

  • Diagnostic Radiology Physician
  • Carlsbad, NM
National Provider Identifier
1205917150
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
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

Updated by the provider on May 16, 2008

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)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
50872MedicaidNM

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.