Simply Mobile X-Ray Inc

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

License

CRT-14994 Issued in AZ

Legal business name

SIMPLY MOBILE X-RAY INC

Practice address

3661 W 12TH LN
Yuma, AZ 85364-9107

Phone

(928) 261-6379

Fax

(928) 276-4834

NPI assigned

Sep 15, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Steven Y Chang, R.T.

Title

President

Phone

(928) 261-6379

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Portable X-ray supplier certification: CCN 03X0009826

Legal name

SIMPLY MOBILE XRAY

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Jun 11, 2009

Last certification

Jan 20, 2023

Ownership / control type

Corporation

Facility address

3661 West 12TH Lane
Yuma, AZ 85364

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367539200000",
    "number": "1679722615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3661 W 12TH LN",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853649107",
            "telephone_number": "928-261-6379",
            "fax_number": "928-276-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 W 12TH LN",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853649107",
            "telephone_number": "928-261-6379",
            "fax_number": "928-276-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLY MOBILE X-RAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-15",
        "last_updated": "2013-05-03",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-261-6379",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.T."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "CA",
            "license": "RHT 92930",
            "primary": false
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "AZ",
            "license": "CRT-14994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "P00733483",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "443363",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Nicole Sieban
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• Frida K Silva Ruiz
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• Alma Simpson, LCSW
• Meghan Elizabeth Simpson, APRN-RNP
• Shauna Heather Simpson, NP
• Jacey May Sims, PHARMD
• Gurpreet Kaur Singh, MD

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.