NPIMap

Organization Active NPI

Professional Portable Radiologic Services Inc

  • Physiological Laboratory
  • Lewes, DE
National Provider Identifier
1447061908
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
PROFESSIONAL PORTABLE RADIOLOGIC SERVICES INC
Practice address
17527 Nassau Commons Blvd Ste 112
Lewes, DE 19958-6283
Phone
(866) 895-2120
NPI assigned
Jan 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Authorized official

Name
Bruce Johnson
Title
VP/Ogc
Phone
(303) 589-4149

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

17527 Nassau Commons Blvd Ste 112
Lewes, DE 19958-6283

Mailing address

3825 N Lafayette St
Denver, CO 80205-3316

National Provider Directory

National Provider Directory
Tax ID family
Professional Portable Radiologic Services Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1447061908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 N LAFAYETTE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802053316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17527 NASSAU COMMONS BLVD STE 112",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199586283",
            "telephone_number": "866-895-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PORTABLE RADIOLOGIC SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP/OGC",
        "authorized_official_telephone_number": "303-589-4149"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewes, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.