Active NPI
Intermountain Medical Imaging LLC
- Diagnostic Radiology Physician
- Meridian, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 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, AK
Enrollment records 12
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Diagnostic Radiology Physician
- Eagle, ID
- NPI 1326247511
O20090130000423, O20140210001568, O20230605002415, O20250131000764, O20250911003595, O20250916000462, O20250916002778, O20250919003294, O20250925003077, O20260116002195, O20260129001083, O20260331004140
-
- Diagnostic Radiology Physician
- Boise, ID
- NPI 1669423679
O20090130000423, O20140210001568, O20230605002415, O20250131000764
-
- Diagnostic Radiology Physician
- Meridian, ID
- NPI 1679520415
O20090130000423, O20140210001568, O20230605002415, O20250131000764, O20250911003595, O20250916000462, O20250916002778, O20250919003294, O20250925003077, O20260116002195, O20260129001083, O20260331004140
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D2302541 | Intermountain Medical Imaging LLC | Certificate of waiver | Apr 10, 2028 |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Diagnostic Radiology Physician
- Boise, ID
- NPI 1730717265
-
- Diagnostic Radiology Physician
- Richmond, VA
- NPI 1235422619
-
- Diagnostic Radiology Physician
- Corinth, TX
- NPI 1487858569
-
- Diagnostic Radiology Physician
- Silverdale, WA
- NPI 1235171547
-
- Diagnostic Radiology Physician
- Lexington, MA
- NPI 1720072697
-
- Diagnostic Radiology Physician
- Boise, ID
- NPI 1003306754
-
- Physician Assistant
- Boise, ID
- NPI 1396394292
-
- Diagnostic Radiology Physician
- Boise, ID
- NPI 1912205675
-
- Diagnostic Radiology Physician
- Boise, ID
- NPI 1033641030
-
- Diagnostic Radiology Physician
- Boise, ID
- NPI 1669961835
-
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1629411335
-
- Diagnostic Radiology Physician
- Seattle, WA
- NPI 1447613542
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
- Integricare, Inc.
- Integricare, Inc.
- Intergity Business Consulting LLC
- Intermountain Ambulatory Anesthesia PLLC
- Intermountain Eye and Laser Centers PLLC
- Intermountain Medical Imaging LLC
- Intermountain Physical Therapy Limited Partnership
- Intermountain Physical Therapy Limited Partnership
- Interventional Pain Solutions PLLC
- Intuitively You Nutrition LLC
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.