Active NPI
Shared Imaging LLC
- Computed Tomography Radiologic Technologist
- Phoenix, AZ
National Provider Identifier
1538390737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Computed Tomography Radiologic Technologist
- Legal business name
- SHARED IMAGING LLC
- Practice address
- 4212 N 16TH St
CT Scanner
Phoenix, AZ 85016-5319 - Phone
- (800) 606-0266
- NPI assigned
- Aug 5, 2009
- Last updated
- May 15, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. David Neally
- Title
- Vice President
- Phone
- (800) 606-0266
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mobile Radiology Clinic/Center | 261QR0208X | IL | ||
| Computed Tomography Radiologic Technologist | 2471C3401X | NU | Primary |
Addresses
Primary practice location
4212 N 16TH St
CT Scanner
Phoenix, AZ 85016-5319
Mailing address
801 Phoenix Lake Ave
Streamwood, IL 60107-2363
Phone (800) 606-0266
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 705566 | Medicaid | AZ |
National Provider Directory
National Provider DirectoryLocations
801 Phoenix Lake Ave
Streamwood, IL 60107
88094 Lockbox
Milwaukee, WI 53288
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249430400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1368576000000",
"number": "1538390737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 PHOENIX LAKE AVE",
"city": "STREAMWOOD",
"state": "IL",
"postal_code": "601072363",
"telephone_number": "800-606-0266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4212 N 16TH ST",
"address_2": "CT SCANNER",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850165319",
"telephone_number": "800-606-0266"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHARED IMAGING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-08-05",
"last_updated": "2013-05-15",
"status": "A",
"authorized_official_last_name": "NEALLY",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "800-606-0266",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QR0208X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology, Mobile",
"state": "IL",
"license": null,
"primary": false
},
{
"code": "2471C3401X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Computed Tomography",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "705566",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.