Active NPI
Angela Deneen Priso, RT(R)
- Radiography Radiologic Technologist
- Indianapolis, IN
National Provider Identifier
1538953773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiography Radiologic Technologist
- License
- XT005153
- Practice address
- 3905 Vincennes Rd Ste 303
Indianapolis, IN 46268-3030 - Phone
- (317) 827-5058
- Fax
- (317) 471-3508
- NPI assigned
- Apr 4, 2025
- Last updated
- Jul 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiography Radiologic Technologist | 2471C3402X | XT005153 | IN | Primary |
Addresses
Primary practice location
3905 Vincennes Rd Ste 303
Indianapolis, IN 46268-3030
Mailing address
10849 Meadow Lake Dr
Indianapolis, IN 46229-3513
Phone (317) 371-8298
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| XT005153 | IN | MD | Radiography Radiologic Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana Mobile Radiology LLC | Current | Accepting new patients |
Locations
3905 Vincennes Rd
Ste 303
Indianapolis, IN 46268
Phone (317) 471-3522
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Indianapolis, IN
- NPI 1962206771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752796800000",
"number": "1538953773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10849 MEADOW LAKE DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462293513",
"telephone_number": "317-371-8298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3905 VINCENNES RD STE 303",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462683030",
"telephone_number": "317-827-5058",
"fax_number": "317-471-3508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRISO",
"first_name": "ANGELA",
"middle_name": "DENEEN",
"name_prefix": "Mrs.",
"credential": "RT(R)",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-04",
"last_updated": "2025-07-18",
"certification_date": "2025-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "2471C3402X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiography",
"state": "IN",
"license": "XT005153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.