Organization Active NPI

Desert Rose Management Corp

Doing business as Desert Rose Imaging Center

  • Radiology Clinic/Center
  • Kingman, AZ
National Provider Identifier
1609967645
Registry record updated Aug 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
OTC 3365 Issued in AZ
Legal business name
DESERT ROSE MANAGEMENT CORP
Doing business as
Desert Rose Imaging Center
Practice address
1708 Sycamore Ave
Kingman, AZ 86401-0927
Phone
(928) 681-3600
Fax
(928) 681-3612
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2009

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

Authorized official

Name
Ms. Pamela J Asher
Title
Office Manager
Phone
(816) 587-1818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X OTC 3365 AZ Primary

Addresses

Primary practice location

1708 Sycamore Ave
Kingman, AZ 86401-0927

Mailing address

5800 NW Prairie View Rd
Kansas City, MO 64151-2764
Phone (816) 587-1818

Other identifiers 3

IdentifierTypeStateIssuer
763707MedicaidAZ
AZ0728540OtherAZBCBS
763707OtherAZAHCCCS

Other names 1

  • Desert Rose Imaging Center Doing business as

National Provider Directory

National Provider Directory

Locations

1708 Sycamore Ave
Ste A
Kingman, AZ 86409
Phone (928) 681-3600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249257600000",
    "number": "1609967645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 NW PRAIRIE VIEW RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512764",
            "telephone_number": "816-587-1818",
            "fax_number": "816-505-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 SYCAMORE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864010927",
            "telephone_number": "928-681-3600",
            "fax_number": "928-681-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT ROSE MANAGEMENT CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2009-08-03",
        "status": "A",
        "authorized_official_last_name": "ASHER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-587-1818",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "AZ",
            "license": "OTC 3365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "763707",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0728540",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "763707",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Rose Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingman, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; 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.