Advantage Diagnostic Imaging Center

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

ADVANTAGE DIAGNOSTIC IMAGING CENTER

Practice address

2980 S Jones Blvd
Suite E
Las Vegas, NV 89146-5656

Phone

(708) 478-6417

Fax

(708) 535-8087

NPI assigned

Apr 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jim Kolb

Title

Executive Vice President

Phone

(708) 478-6403

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306969621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 S JONES BLVD",
            "address_2": "SUITE E",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465656",
            "telephone_number": "708-478-6417",
            "fax_number": "708-535-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 S JONES BLVD",
            "address_2": "SUITE E",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465656",
            "telephone_number": "708-478-6417",
            "fax_number": "708-535-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE DIAGNOSTIC IMAGING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOLB",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "708-478-6403",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Exclusive Provider Organization in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.