Organization Active NPI

Smi Imaging, LLC

  • Diagnostic Radiology Physician
  • Surprise, AZ
National Provider Identifier
1568784353
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OTC4917 Issued in AZ
Legal business name
SMI IMAGING, LLC
Practice address
14823 W Bell Rd
Suite 110
Surprise, AZ 85374-7607
Phone
(623) 214-1492
Fax
(623) 546-5783
NPI assigned
Feb 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Authorized official

Name
Howard J Simon, M.D.
Title
President
Phone
(480) 264-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X OTC4917 AZ Primary

Addresses

Primary practice location

14823 W Bell Rd
Suite 110
Surprise, AZ 85374-7607

Mailing address

PO Box 7368
Orange, CA 92863-7368
Phone (714) 571-5000

Other identifiers 1

IdentifierTypeStateIssuer
571290MedicaidAZ

Other names 1

  • SimonMed Imaging - Stadium Village Other name

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1568784353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7368",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928637368",
            "telephone_number": "714-571-5000",
            "fax_number": "714-571-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14823 W BELL RD",
            "address_2": "SUITE 110",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747607",
            "telephone_number": "623-214-1492",
            "fax_number": "623-546-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMI IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-19",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-264-2400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "OTC4917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "571290",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SimonMed Imaging - Stadium Village",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.