Organization Active NPI

Shared Imaging LLC

  • Computed Tomography Radiologic Technologist
  • Phoenix, AZ
National Provider Identifier
1538390737
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Computed Tomography Radiologic TechnologistTaxonomy code 2471C3401X
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, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
705566MedicaidAZ

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.