Summit Imaging LLC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

SUMMIT IMAGING LLC

Doing business as

Clovis Open MRI

Practice address

821 Lexington Rd
Clovis, NM 88101-4466

Phone

(575) 763-6144

Fax

(575) 763-6147

NPI assigned

Sep 22, 2006

Last updated

Oct 3, 2022By 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

Jesse Martin

Title

Owner

Phone

(575) 763-6144

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Clovis Open MRI Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stacey Renee Dodd, D.C

  • Chiropractor
  • Clovis, NM
  • NPI 1013288232
  NPD

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1497855381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 LEXINGTON RD",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014466",
            "telephone_number": "575-763-6144",
            "fax_number": "575-763-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 LEXINGTON RD",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014466",
            "telephone_number": "575-763-6144",
            "fax_number": "575-763-6147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-763-6144"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95687262",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04074975",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00182692",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00182692",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "summitimg.com",
            "affiliation": "N",
            "address_1": "821 Lexington Rd",
            "city": "Clovis",
            "state": "NM",
            "country_code": "US",
            "postal_code": "881014466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clovis Open MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Magnetic Resonance Imaging (MRI) Clinic/Center in Clovis, NM
• Providers in Clovis, NM by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.