Alaska Innovative Imaging, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

420293 Issued in AK

Legal business name

ALASKA INNOVATIVE IMAGING, LLC

Practice address

2110 E Northern Lights Blvd
Suite 101
Anchorage, AK 99508-4102

Phone

(907) 561-9191

Fax

(907) 561-0097

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Tara Elliston

Title

Lead MRI Technician

Phone

(907) 561-9191

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215053202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 E NORTHERN LIGHTS BLVD",
            "address_2": "SUITE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084102",
            "telephone_number": "907-561-9191",
            "fax_number": "907-561-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 E NORTHERN LIGHTS BLVD",
            "address_2": "SUITE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084102",
            "telephone_number": "907-561-9191",
            "fax_number": "907-561-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKA INNOVATIVE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLISTON",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "LEAD MRI TECHNICIAN",
        "authorized_official_telephone_number": "907-561-9191"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AK",
            "license": "420293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaska Hospitalist Group LLC
• Alaska Human Services
• Alaska Human Services, Inc.
• Alaska Imaging Associates, LLC
• Alaska Independent Care Coordination
• Alaska Innovative Medicine, Inc.
• Alaska Innovative Remodeling, Inc.
• Alaska Inpatient Neurology Services, LLC
• Alaska Integrative Medicine
• Alaska Integrative Psychiatry LLC

• All providers in Anchorage, AK
• Diagnostic Radiology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.