NPIMap

Organization Active NPI

Indian Wells Ultrasound Imaging Inc

  • Radiology Clinic/Center
  • Las Cruces, NM
National Provider Identifier
1215016415
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
106930 Issued in NM
Legal business name
INDIAN WELLS ULTRASOUND IMAGING INC
Practice address
205 W Boutz Rd. BLDG #1
Las Cruces, NM 88005
Phone
(505) 532-7000
Fax
(505) 532-7129
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Mr. Charles Jackson Wooddell, RDMS
Title
President
Phone
(505) 443-0339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 106930 NM Primary

Addresses

Primary practice location

205 W Boutz Rd. BLDG #1
Las Cruces, NM 88005

Mailing address

PO Box 1744
Alamogordo, NM 88311-1744
Phone (505) 443-0339

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1215016415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1744",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883111744",
            "telephone_number": "505-443-0339",
            "fax_number": "505-434-5624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W BOUTZ RD. BLDG #1",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88005",
            "telephone_number": "505-532-7000",
            "fax_number": "505-532-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN WELLS ULTRASOUND IMAGING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "WOODDELL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-443-0339",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RDMS"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NM",
            "license": "106930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.