Organization Active NPI

Intermountain Medical Imaging LLC

  • Diagnostic Radiology Physician
  • Meridian, ID
National Provider Identifier
1598524696
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
INTERMOUNTAIN MEDICAL IMAGING LLC
Practice address
875 S Vanguard Way Ste 100
Meridian, ID 83642-8541
Phone
(208) 954-8100
Fax
(208) 947-3322
NPI assigned
Mar 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Authorized official

Name
Norman Hames
Title
Ceo
Phone
(585) 218-8015

Specialties & licenses 1

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

Addresses

Primary practice location

875 S Vanguard Way Ste 100
Meridian, ID 83642-8541

Mailing address

PO Box 4568
Portland, OR 97208-4568
Phone (208) 991-5212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR, VA, GA, TX, WA, MA, NV, UT, MN, WI, AK12 enrollments

Enrollment records 12

Enrollment IDStateProvider typePAC IDDetails
O20090130000423 ID Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 39 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Meridian, ID; Sun Valley, ID; Ketchum, ID; Eagle, ID; Boise, ID
O20140210001568 OR Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 1 practitioner
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR
O20230605002415 VA Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 1 practitioner
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlottesville, VA
O20250131000764 GA Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 2 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Johns Creek, GA; Buford, GA
O20250911003595 TX Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coppell, TX
O20250916000462 WA Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bainbridge Island, WA
O20250916002778 MA Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lexington, MA
O20250919003294 NV Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Las Vegas, NV
O20250925003077 UT Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Park City, UT
O20260116002195 MN Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rochester, MN
O20260129001083 WI Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wauwatosa, WI
O20260331004140 AK Part B Supplier - Clinic/Group Practice 7517870918 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eagle River, AK

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2302541Intermountain Medical Imaging LLC875 S Vanguard Ste 100, Meridian, ID 83642Certificate of waiverApr 10, 2028

National Provider Directory

National Provider Directory

Locations

877 W Main St
Ste 603
Boise, ID 83702
Phone (208) 367-2161

875 S Vanguard Way
Ste 100
Meridian, ID 83642
Phone (208) 954-8100

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1598524696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4568",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084568",
            "telephone_number": "208-991-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 S VANGUARD WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428541",
            "telephone_number": "208-954-8100",
            "fax_number": "208-947-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN MEDICAL IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "HAMES",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "585-218-8015"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.