NPIMap

Organization Active NPI

Elite View Imaging LLC

  • Diagnostic Neuroimaging (Radiology) Physician
  • Phoenix, AZ
National Provider Identifier
1649643602
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Neuroimaging (Radiology) PhysicianTaxonomy code 2085D0003X
License
OTC5077 Issued in AZ
Legal business name
ELITE VIEW IMAGING LLC
Practice address
1110 E Missouri Ave
Suite 140
Phoenix, AZ 85014-2707
Phone
(602) 274-4674
Fax
(602) 274-6060
NPI assigned
Nov 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Authorized official

Name
Mr. Stephen Scott Broussard
Title
President
Phone
(337) 349-4562

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Radiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085D0003X OTC5077 AZ Primary

Addresses

Primary practice location

1110 E Missouri Ave
Suite 140
Phoenix, AZ 85014-2707

Mailing address

PO Box 857
Coppell, TX 75019-0857
Phone (337) 886-0883

Other names 1

  • Elite View Starolup Holdings Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elite View Imaging LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1110 E Missouri Ave
Ste 140
Phoenix, AZ 85014
Phone (602) 274-4674

NPI Registry JSON

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1649643602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 857",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750190857",
            "telephone_number": "337-886-0883",
            "fax_number": "337-886-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 E MISSOURI AVE",
            "address_2": "SUITE 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142707",
            "telephone_number": "602-274-4674",
            "fax_number": "602-274-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE VIEW IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-12",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "BROUSSARD",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-349-4562",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085D0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "AZ",
            "license": "OTC5077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite View Starolup Holdings",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.