Diagnostic Imaging Service of Idaho

Primary specialty

Radiography Radiologic TechnologistTaxonomy code 2471C3402X

Legal business name

DIAGNOSTIC IMAGING SERVICE OF IDAHO

Practice address

1951 Bench Rd
Suite F
Pocatello, ID 83201-2073

Phone

(208) 237-0977

Fax

(208) 237-0985

NPI assigned

Aug 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. James Jay Everson, RDMS

Title

Owner

Phone

(208) 237-0977

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 6

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

• Casey I Huntsman, M.D.

  • Orthopaedic Surgery Physician
  • Idaho Falls, ID
  • NPI 1932136512
  NPD
• Justin A Lamb, D.O.

  • Diagnostic Radiology Physician
  • Idaho Falls, ID
  • NPI 1417915430
  NPD
• Lance Spencer Longmore, D.O.

  • Clinical Cardiac Electrophysiology Physician
  • Pocatello, ID
  • NPI 1447266267
  NPD
• Lisa A Bosworth, PA

  • Physician Assistant
  • Pocatello, ID
  • NPI 1730372756
  NPD (past)
• Jordan T Hammon, DO

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1518532464
  NPD (past)
• Brandon A. West, D.O.

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1750490660
  NPD (past)

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1508875360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 BENCH RD",
            "address_2": "SUITE F",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012073",
            "telephone_number": "208-237-0977",
            "fax_number": "208-237-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 BENCH RD",
            "address_2": "SUITE F",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012073",
            "telephone_number": "208-237-0977",
            "fax_number": "208-237-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC IMAGING SERVICE OF IDAHO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "EVERSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-237-0977",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RDMS"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Radiography",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804301300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Radiography Radiologic Technologist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Radiography Radiologic Technologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.