NPIMap

Organization Active NPI

Modern Interventional Radiology, LLC

  • Specialist
  • Phoenix, AZ
National Provider Identifier
1356732168
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MODERN INTERVENTIONAL RADIOLOGY, LLC
Practice address
1301 E McDowell Rd
Suite 100
Phoenix, AZ 85006-2621
Phone
(602) 265-8800
Fax
(602) 265-8151
NPI assigned
Feb 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Authorized official

Name
Leslie Daugherty
Title
Administrator
Phone
(602) 265-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1301 E McDowell Rd
Suite 100
Phoenix, AZ 85006-2621

Mailing address

1301 E McDowell Rd
Suite 100
Phoenix, AZ 85006-2621
Phone (602) 265-8800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424044800000",
    "number": "1356732168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E MCDOWELL RD",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062621",
            "telephone_number": "602-265-8800",
            "fax_number": "602-265-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E MCDOWELL RD",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062621",
            "telephone_number": "602-265-8800",
            "fax_number": "602-265-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN INTERVENTIONAL RADIOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-16",
        "last_updated": "2015-02-16",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-265-8800"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.