NPIMap

Organization Active NPI

Clearview Digital Image LLC

  • Mobile Radiology Clinic/Center
  • Little Rock, AR
National Provider Identifier
1316464878
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
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 25, 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 S. Sams
Title
Member
Phone
(501) 214-1788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X 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
O20180503000369 AR Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4880955665 Practice locations: Little Rock, AR

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.

Locations

16502 Lawson Rd
Ste A
Little Rock, AR 72210
Phone (501) 214-1788

1 Riverfront Pl
Ste 555
North Little Rock, AR 72114
Phone (479) 214-1788

Practitioners & affiliated clinicians

Practitioners 5

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": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1316464878",
    "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": "2017-08-25",
        "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": "S.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "501-214-1788"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "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

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.