NPIMap

Organization Active NPI

Assured Imaging Women's Wellness of Southern Arizona, LLC

Doing business as Assured Imaging Women's Wellness

  • Diagnostic Radiology Physician
  • Arlington, TX
National Provider Identifier
1528566890
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ASSURED IMAGING WOMEN'S WELLNESS OF SOUTHERN ARIZONA, LLC
Doing business as
Assured Imaging Women's Wellness
Practice address
3901 Arlington Highlands Blvd Ste 200
Arlington, TX 76018-6050
Phone
(888) 233-6121
NPI assigned
Jan 31, 2018
Last updated
May 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Authorized official

Name
Jin Kim
Title
Ceo
Phone
(312) 774-8828

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Medical Specialty Clinic/Center 261QM2500X NU
Mobile Mammography Clinic/Center 261QR0207X NU
Mobile Radiology Clinic/Center 261QR0208X NU
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

3901 Arlington Highlands Blvd Ste 200
Arlington, TX 76018-6050

Mailing address

7717 N Hartman LN
Tucson, AZ 85743-5800
Phone (888) 233-6121

Other names 1

  • Assured Imaging Women's Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201021001716 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5799880761 Practice locations: Arlington, TX

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

5801 Oakbend Trl
Ste 265
Fort Worth, TX 76132

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1528566890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7717 N HARTMAN LN",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857435800",
            "telephone_number": "888-233-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 ARLINGTON HIGHLANDS BLVD STE 200",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760186050",
            "telephone_number": "888-233-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSURED IMAGING WOMEN'S WELLNESS OF SOUTHERN ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-31",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-774-8828"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0207X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile Mammography",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Assured Imaging Women's Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.