NPIMap

Organization Active NPI

Professional Portable Radiologic Services, Inc.

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Glendale, AZ
National Provider Identifier
1285873810
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
License
MED6719-M3XR11 Issued in AZ
Legal business name
PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC.
Practice address
6314 W Union Hills Dr
Glendale, AZ 85308-1001
Phone
(866) 895-2119
Fax
(952) 890-9025
NPI assigned
Feb 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Authorized official

Name
Bruce Allen Johnson
Title
VP-Ao
Phone
(303) 589-4149

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X MED6719-M3XR11 AZ Primary

Addresses

Primary practice location

6314 W Union Hills Dr
Glendale, AZ 85308-1001

Mailing address

755 Cliff Rd E
Burnsville, MN 55337-1545
Phone (612) 369-1991

Other names 3

  • Professional Portable X-ray, Inc. Doing business as
  • PPX Other name
  • Professional Portable X-ray Other name

National Provider Directory

National Provider Directory
Tax ID family
Professional Portable Radiologic Services Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

9132 W Cactus Rd
Ste D
Peoria, AZ 85381

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743379200000",
    "number": "1285873810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 CLIFF RD E",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371545",
            "telephone_number": "612-369-1991",
            "fax_number": "952-890-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6314 W UNION HILLS DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081001",
            "telephone_number": "866-895-2119",
            "fax_number": "952-890-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-04",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "VP-AO",
        "authorized_official_telephone_number": "303-589-4149"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "AZ",
            "license": "MED6719-M3XR11",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Portable X-ray, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PPX",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Professional Portable X-ray",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.