NPIMap

Organization Active NPI

Clearview Digital Image LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Little Rock, AR
National Provider Identifier
1316463227
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
CLEARVIEW DIGITAL IMAGE LLC
Practice address
16502 Lawson Rd Ste a
Little Rock, AR 72210-2020
Phone
(501) 214-1788
NPI assigned
Aug 22, 2017
Last updated
Jun 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Authorized official

Name
Jerry D Sams
Title
Member
Phone
(501) 214-1788

Specialties & licenses 1

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

Addresses

Primary practice location

16502 Lawson Rd Ste a
Little Rock, AR 72210-2020

Mailing address

415 Rogers Ave
Fort Smith, AR 72901-1903
Phone (479) 783-4672

Other identifiers 1

IdentifierTypeStateIssuer
231539710MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180220000724 AR Part B Supplier - Portable X-Ray Supplier 4880955665 Practice locations: Little Rock, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316463227. Details of each certification follow.

Portable X-ray supplier certification: CCN 04X0009830

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CLEARVIEW DIGITAL IMAGE, LLC
Certification status
Active
Provider type (POS)
Portable X-ray supplier
Participating since
May 22, 2018
Last certification
May 22, 2018
Ownership / control type
Corporation
Facility address
16502 Lawson Road, Suite a
Little Rock, AR 72210

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Clearview Digital Image LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1316463227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729011903",
            "telephone_number": "479-783-4672",
            "fax_number": "479-783-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16502 LAWSON RD STE A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722102020",
            "telephone_number": "501-214-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARVIEW DIGITAL IMAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "SAMS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "501-214-1788"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231539710",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.