Northern Utah Imaging LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

NORTHERN UTAH IMAGING LLC

Doing business as

MillCreek Imaging

Practice address

3738 S 900 E
Salt Lake City, UT 84106-1913

Phone

(801) 313-1955

Fax

(801) 313-1965

NPI assigned

Oct 18, 2005

Last updated

Nov 8, 2010By 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. Lavelle Hardin

Title

Imaging & Oncology Managed Care

Phone

(615) 372-5441

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MillCreek Imaging Doing business as

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1487643904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3738 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061913",
            "telephone_number": "801-313-1955",
            "fax_number": "801-313-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3738 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061913",
            "telephone_number": "801-313-1955",
            "fax_number": "801-313-1965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN UTAH IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "LAVELLE",
        "authorized_official_title_or_position": "IMAGING & ONCOLOGY MANAGED CARE",
        "authorized_official_telephone_number": "615-372-5441",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00141132",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MillCreek Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Diagnostic Radiology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Diagnostic Radiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.