NPIMap

Organization Active NPI

Mission Medical Imaging

  • Diagnostic Radiology Physician
  • Salem, OR
National Provider Identifier
1306893979
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MISSION MEDICAL IMAGING
Practice address
1155 Mission St SE
Suite 105
Salem, OR 97302-6228
Phone
(503) 362-0254
NPI assigned
May 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Authorized official

Name
Mr. Thomas Chambers, R.T.(R).
Title
General Manager
Phone
(503) 362-0254

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1155 Mission St SE
Suite 105
Salem, OR 97302-6228

Mailing address

PO Box 191
Salem, OR 97308-0191
Phone (503) 362-0254

Other identifiers 1

IdentifierTypeStateIssuer
178384MedicaidOR

National Provider Directory

National Provider Directory

Locations

210 W Ellendale Ave
Ste 104
Dallas, OR 97338
Phone (503) 362-0254

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1306893979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973080191",
            "telephone_number": "503-362-0254",
            "fax_number": "503-362-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 MISSION ST SE",
            "address_2": "SUITE 105",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026228",
            "telephone_number": "503-362-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION MEDICAL IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "503-362-0254",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.T.(R)."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178384",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.