Southwest Mobile Diagnostic

Primary specialty

Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X

Legal business name

SOUTHWEST MOBILE DIAGNOSTIC

Practice address

RR2 Riverbend
Est No 26
Bluefield, VA 24605-0026

Phone

(276) 322-4520

Fax

(276) 322-4520

NPI assigned

Nov 24, 2006

Last updated

Jul 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Marcelo Lapurga Santiago Jr., SONAGRAPHER

Title

Owner

Phone

(276) 322-4520

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1457427387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 797",
            "city": "NORTH TAZEWELL",
            "state": "VA",
            "postal_code": "246300797",
            "telephone_number": "276-322-4520",
            "fax_number": "276-322-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR2 RIVERBEND",
            "address_2": "EST NO 26",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "246050026",
            "telephone_number": "276-322-4520",
            "fax_number": "276-322-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST MOBILE DIAGNOSTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "MARCELO",
        "authorized_official_middle_name": "LAPURGA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-322-4520",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "SONAGRAPHER"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0036569000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004990200",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Misty M Short Cline, DDS
• Joshua Shroyer, ATC
• Brandy L Smith, LPC
• Broc Smith
• Paige Kerrigan Smith, OD
• Melissa Nickels Stacy, P.A.C.
• Robert Eugene Stallard II, PHARMD
• Susie Jennings Stauffer
• Kristy Michelle Stout
• Surgical Care of the Virginias, LLC

• Diagnostic Ultrasound Physician in Bluefield, VA
• Providers in Bluefield, VA by specialty
• Diagnostic Ultrasound Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.