Organization Active NPI

Medical Xray Center PC

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
National Provider Identifier
1326187477
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MEDICAL XRAY CENTER PC
Practice address
1417 S Minnesota Ave
Sioux Falls, SD 57105-1715
Phone
(605) 336-0517
Fax
(605) 336-2874
NPI assigned
Feb 5, 2007
Last updated
Oct 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Mr. Gerald Lloyd Larson
Title
Business Administrator
Phone
(605) 731-7522

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0001X
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1417 S Minnesota Ave
Sioux Falls, SD 57105-1715

Mailing address

1417 S Minnesota Ave
Sioux Falls, SD 57105-1715
Phone (605) 336-0517

Other identifiers 1

IdentifierTypeStateIssuer
7202240MedicaidSD

National Provider Directory

National Provider Directory

Locations

917 N Washington Ave
Madison, SD 57042
Phone (605) 256-6551

800 E 21st St
#300
Sioux Falls, SD 57105
Phone (605) 734-5511

Practitioners & affiliated clinicians

Practitioners 2

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": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1326187477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051715",
            "telephone_number": "605-336-0517",
            "fax_number": "605-336-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051715",
            "telephone_number": "605-336-0517",
            "fax_number": "605-336-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL XRAY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "605-731-7522",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7202240",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.