Independence Imaging

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

1049853 Issued in AK

Legal business name

INDEPENDENCE IMAGING

Practice address

291 N Fireweed St
Soldotna, AK 99669-7540

Phone

(907) 262-6454

NPI assigned

Mar 15, 2017

Organization subpart

Yes

Parent organization

INDEPENDENCE HEALTHCAREAs reported in NPPES

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

Authorized official

Name

Mercy Berg

Title

Office Manager

Phone

(907) 262-6454

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Independence Imaging2 organizations share this tax ID, including this one

Part of

Independence Imaging

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Independence Healthcare

  • Multi-Specialty Clinic/Center
  • Soldotna, AK
  • NPI 1427598978
  NPD tax ID

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489536000000",
    "number": "1245771864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 N FIREWEED ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 N FIREWEED ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697540",
            "telephone_number": "907-262-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE IMAGING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDEPENDENCE HEALTHCARE",
        "enumeration_date": "2017-03-15",
        "last_updated": "2017-03-15",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MERCY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "907-262-6454"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AK",
            "license": "1049853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "1049853",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corey Hux, RN
• Independence Healthcare
• Independence Healthcare PC (Independence Therapy)
• Independence Healthcare PC (Corvus Neurology)
• Independence Healthcare PC
• Inlet Clinical Services LLC
• Inlet Pharmacy Group Inc. (Soldotna Professional Pharmacy)
• Inlet Pharmacy Group Inc. (Soldotna Professional Pharmacy)
• David Scott Innes, M.D.
• Innovative Sleep Solutions, LLC

• Diagnostic Radiology Physician in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Diagnostic Radiology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.