Organization Active NPI

Smi Imaging, LLC

  • Diagnostic Radiology Physician
  • Gilbert, AZ
National Provider Identifier
1356574537
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OTC4698 Issued in AZ
Legal business name
SMI IMAGING, LLC
Practice address
2680 S Val Vista Dr BLDG 7
Suite 135
Gilbert, AZ 85295-2152
Phone
(480) 584-4900
Fax
(480) 584-4910
NPI assigned
Sep 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
Howard J Simon, M.D.
Title
President
Phone
(480) 264-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X OTC4698 AZ Primary

Addresses

Primary practice location

2680 S Val Vista Dr BLDG 7
Suite 135
Gilbert, AZ 85295-2152

Mailing address

PO Box 7368
Orange, CA 92863-7368
Phone (714) 571-5000

Other identifiers 2

IdentifierTypeStateIssuer
473154MedicaidAZ
P00811052OtherRAILROAD MEDICARE

Other names 1

  • SimonMed Imaging - Spectrum Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1098155Simonmed Imaging - Spectrum2680 S Val Vista Drive BLDG 7 Ste 135, Gilbert, AZ 85295Certificate of waiverJan 9, 2027

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1356574537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7368",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928637368",
            "telephone_number": "714-571-5000",
            "fax_number": "714-571-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 S VAL VISTA DR BLDG 7",
            "address_2": "SUITE 135",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952152",
            "telephone_number": "480-584-4900",
            "fax_number": "480-584-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMI IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-03",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-264-2400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "OTC4698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "473154",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00811052",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SimonMed Imaging - Spectrum",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.