NPIMap

Organization Active NPI

Mantro Mobile Imaging LLC

  • Radiography Radiologic Technologist
  • Las Vegas, NV
National Provider Identifier
1285789370
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
2000422.320 Issued in NV
Legal business name
MANTRO MOBILE IMAGING LLC
Practice address
8778 S Maryland Pkwy
Suite 105
Las Vegas, NV 89123-6704
Phone
(702) 896-0473
Fax
(702) 586-0528
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Authorized official

Name
John Missig
Title
President/Ceo
Phone
(434) 989-8851

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471C3402X 2000422.320 NV Primary
Mobile Radiology Clinic/Center 261QR0208X

Addresses

Primary practice location

8778 S Maryland Pkwy
Suite 105
Las Vegas, NV 89123-6704

Mailing address

8778 S Maryland Pkwy
Suite 105
Las Vegas, NV 89123-6704
Phone (702) 896-0473

Other identifiers 1

IdentifierTypeStateIssuer
29X0009810MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070328000064 NV Part B Supplier - Portable X-Ray Supplier 3476657669 Practice locations: Las Vegas, NV

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mantro Mobile Imaging LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

8778 S Maryland Pkwy
Las Vegas, NV 89123
Phone (725) 500-4645

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1285789370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8778 S MARYLAND PKWY",
            "address_2": "SUITE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891236704",
            "telephone_number": "702-896-0473",
            "fax_number": "702-586-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8778 S MARYLAND PKWY",
            "address_2": "SUITE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891236704",
            "telephone_number": "702-896-0473",
            "fax_number": "702-586-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANTRO MOBILE IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "MISSIG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "434-989-8851"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Radiography",
            "state": "NV",
            "license": "2000422.320",
            "primary": true
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29X0009810",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; 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.

Verify at the official NPI Registry.