East Side Imaging, LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

EAST SIDE IMAGING, LLC

Doing business as

RAYUS RADIOLOGY

Practice address

3702 S State St Ste 111
South Salt Lake, UT 84115-5078

Phone

(801) 288-9671

Fax

(801) 288-9583

NPI assigned

Jul 31, 2018

Organization subpart

No

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

Authorized official

Name

Albert C. Van Kirk

Title

President and Ceo

Phone

(330) 653-3968

Specialties & licenses 1

Addresses

Other names 1

• RAYUS RADIOLOGY Doing business as

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628640000000",
    "number": "1316425432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645846",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452645846",
            "telephone_number": "866-674-7933",
            "fax_number": "952-513-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 S STATE ST STE 111",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841155078",
            "telephone_number": "801-288-9671",
            "fax_number": "801-288-9583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-31",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "VAN KIRK",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "330-653-3968"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAYUS RADIOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Landon Dickson, M.D.
• Sara Dillon, LCSW
• Miroslav Dinic
• Lhamo Dolkar
• Joshua T Dunn
• Samantha Einfeldt, BSN, RN
• Amy Elms
• Ayelet Kol Engelman, LPC
• Shandi Brianne Engman, LCSW
• Julia Enya Tagulinao Escalona

• Physiological Laboratory in South Salt Lake, UT
• Providers in South Salt Lake, UT by specialty
• Physiological Laboratory in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.