Axon Iom LLC

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

Legal business name

AXON IOM LLC

Practice address

1110 E 400 N
Kaysville, UT 84037-1754

Phone

(385) 245-3580

NPI assigned

Apr 11, 2019

Organization subpart

No

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

Authorized official

Name

Dallas Ward, CNIM, DCNPI 1356350987

Title

Member/ Registered Agent

Phone

(385) 245-3580

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dallas Ward, CNIM

  • Electroneurodiagnostic Specialist/Technologist
  • Kaysville, UT
  • NPI 1356350987

  Electroneurodiagnostic

  NPD Authorized official

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1447713888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 E 400 N",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371754",
            "telephone_number": "385-245-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 E 400 N",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371754",
            "telephone_number": "385-245-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXON IOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "DALLAS",
        "authorized_official_title_or_position": "MEMBER/ REGISTERED AGENT",
        "authorized_official_telephone_number": "385-245-3580",
        "authorized_official_credential": "CNIM, DC"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.