Active NPI
White Mountain Radiology
- Diagnostic Radiology Physician
- Show Low, AZ
National Provider Identifier
1225018146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- WHITE MOUNTAIN RADIOLOGY
- Practice address
- 2200 E Show Low Lake Rd
Show Low, AZ 85901-7881 - Phone
- (928) 537-6338
- Fax
- (928) 532-5947
- NPI assigned
- Jan 18, 2006
- Last updated
- Oct 19, 2026
- 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
- Grant Berges
- Title
- MD- President
- Phone
- (928) 537-6338
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | AZ | Primary |
Addresses
Primary practice location
2200 E Show Low Lake Rd
Show Low, AZ 85901-7881
Mailing address
DPT 880325 PO Box 29650
Phoenix, AZ 85038-9650
Phone (866) 264-3435
Other practice location 1
4951 S White Mountain Rd
Show Low, AZ 85901-7827
Phone (866) 264-3435
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/ | Other | Management Services Network, LLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, WA, UT, HI, GA, VA, SC, CO, IL, TX, PA, OH, MD, FL, NY, WI, MS, KS, MI, MA, NV
Enrollment records 21
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 60
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Diagnostic Radiology Physician
- Show Low, AZ
- NPI 1447380977
-
- Diagnostic Radiology Physician
- Phoenix, AZ
- NPI 1538587365
-
- Diagnostic Radiology Physician
- Tucson, AZ
- NPI 1437456589
-
- Diagnostic Radiology Physician
- Show Low, AZ
- NPI 1972583797
-
- Diagnostic Radiology Physician
- Honolulu, HI
- NPI 1154311694
-
- Diagnostic Radiology Physician
- New Albany, OH
- NPI 1033193941
-
- Diagnostic Radiology Physician
- Wellington, FL
- NPI 1225076219
-
- Diagnostic Radiology Physician
- Clayton, GA
- NPI 1386688851
-
- Diagnostic Radiology Physician
- Hays, KS
- NPI 1457313413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1792368000000",
"number": "1225018146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DPT 880325 PO BOX 29650",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850389650",
"telephone_number": "866-264-3435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 E SHOW LOW LAKE RD",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859017881",
"telephone_number": "928-537-6338",
"fax_number": "928-532-5947"
}
],
"practiceLocations": [
{
"address_1": "4951 S White Mountain Rd",
"address_purpose": "LOCATION",
"city": "Show Low",
"state": "AZ",
"postal_code": "859017827",
"country_code": "US",
"telephone_number": "866-264-3435",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "WHITE MOUNTAIN RADIOLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-18",
"last_updated": "2026-10-19",
"certification_date": "2026-10-19",
"status": "A",
"authorized_official_last_name": "BERGES",
"authorized_official_first_name": "GRANT",
"authorized_official_title_or_position": "MD- PRESIDENT",
"authorized_official_telephone_number": "928-537-6338"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "AZ",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.1036.1",
"affiliationName": "Management Services Network, LLC",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "2357 Warm Springs Rd Ste 400",
"city": "Columbus",
"state": "GA",
"country_code": "US",
"postal_code": "319046874",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Show Low, AZ
- White Mountain Emergency Physicians, PC
- White Mountain Endodontics PLLC
- White Mountain Meals on Wheels
- White Mountain Pain Associates PC
- White Mountain Physical Therapy LTD
- White Mountain Surgical Specialist
- White Mountain Surgical Specialists PC
- White Mountain Surgical Specialists PC
- Jacqueline Nicole Whiting, MS LASAC
- Jeffrey Whiting, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.