Active NPI
Midwest Internal Medicine PLLC
Doing business as Midwest MRI
- Specialist
- Lake Havasu City, AZ
National Provider Identifier
1619174604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- MIDWEST INTERNAL MEDICINE PLLC
- Doing business as
- Midwest MRI
- Practice address
- 1840 Mesquite Ave
Suite B
Lake Havasu City, AZ 86403-5771 - Phone
- (928) 453-8500
- Fax
- (928) 453-5556
- NPI assigned
- Jul 2, 2007
- Last updated
- Apr 20, 2008
- 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
- Marty Lalande
- Title
- Administrator
- Phone
- (928) 453-8500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
1840 Mesquite Ave
Suite B
Lake Havasu City, AZ 86403-5771
Mailing address
1840 Mesquite Ave
Suite F
Lake Havasu City, AZ 86403-5771
Phone (928) 453-8500
Other names 1
- Midwest MRI
National Provider Directory
National Provider DirectoryLocations
1840 Mesquite Ave
Ste F
Lk Havasu Cty, AZ 86403
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": "1183334400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208649600000",
"number": "1619174604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 MESQUITE AVE",
"address_2": "SUITE F",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864035771",
"telephone_number": "928-453-8500",
"fax_number": "928-453-5556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 MESQUITE AVE",
"address_2": "SUITE B",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864035771",
"telephone_number": "928-453-8500",
"fax_number": "928-453-5556"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIDWEST INTERNAL MEDICINE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-02",
"last_updated": "2008-04-20",
"status": "A",
"authorized_official_last_name": "LALANDE",
"authorized_official_first_name": "MARTY",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "928-453-8500"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Midwest MRI",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lake Havasu City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.