Mobile X-Ray Services LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

MOBILE X-RAY SERVICES LLC

Practice address

9376 Mansfield Rd
Suite B
Shreveport, LA 71118-3181

Phone

(318) 687-6861

Fax

(318) 687-6768

NPI assigned

Oct 18, 2010

Organization subpart

No

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

Authorized official

Name

Jacquelyn C Moore

Title

Managing Member

Phone

(318) 687-6861

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Portable X-ray supplier certification: CCN 19X0009803

Legal name

MOBILE X RAY SERVICE OF SHREVEPORT BOSSIER

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Jan 6, 1982

Last certification

Oct 12, 2022

Ownership / control type

Corporation

Most recent change of ownership

Oct 12, 2018

Facility address

9376 Mansfield Rd.
Shreveport, LA 71118

Locations

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1437469004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9376 MANSFIELD RD",
            "address_2": "SUITE B",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183181",
            "telephone_number": "318-687-6861",
            "fax_number": "318-687-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9376 MANSFIELD RD",
            "address_2": "SUITE B",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183181",
            "telephone_number": "318-687-6861",
            "fax_number": "318-687-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE X-RAY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "318-687-6861"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ashish G Modi, PHARM.D
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• Malak Prakashbhai Modi, MD

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.