Portable Imaging of Arizona, LLC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

PORTABLE IMAGING OF ARIZONA, LLC

Practice address

2338 W Royal Palm Rd
Suite a
Phoenix, AZ 85021-9339

Phone

(602) 864-3656

Fax

(602) 864-3660

NPI assigned

Sep 23, 2008

Organization subpart

No

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

Authorized official

Name

Abby Grossa

Title

Cfo

Phone

(702) 939-6559

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236816000000",
    "number": "1215187570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5538 DUNCAN DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891302812",
            "telephone_number": "702-939-6559",
            "fax_number": "702-939-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 W ROYAL PALM RD",
            "address_2": "SUITE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850219339",
            "telephone_number": "602-864-3656",
            "fax_number": "602-864-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTABLE IMAGING OF ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2009-03-12",
        "status": "A",
        "authorized_official_last_name": "GROSSA",
        "authorized_official_first_name": "ABBY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "702-939-6559"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "389820",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCHOICE",
            "identifier": "389820",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCES",
            "identifier": "389820",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Populo, DNP
• Keith J Porche, MD
• Enriqueta M Porras, M.D.
• Misael Porras
• Vanessa Porras, FNP-C
• Portable X Ray of Arizona LLC
• Portable X Ray of Arizona LLC
• Portable Xray of Arizona Phoenix
• Breanna Portale
• Melissa Portela, A.T.

• Mobile Radiology Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mobile Radiology Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.