Quality Medical Imaging of Utah, Inc

Primary specialty

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

License

63916660161 Issued in UT

Legal business name

QUALITY MEDICAL IMAGING OF UTAH, INC

Practice address

1564 N Overland Trails Dr
Washington, UT 84780-2417

Phone

(702) 839-1133

Fax

(702) 851-1616

NPI assigned

May 28, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Roger C Faselt

Title

President

Phone

(702) 839-1133

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Quality Medical Imaging of Utah, Inc.

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Washington, UT
  • NPI 1407023625

  1254492994

  Same PAC ID

Tax ID family

Quality Medical Imaging of Utah Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Quality Medical Imaging of Utah, Inc.

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Washington, UT
  • NPI 1407023625
  NPD tax ID

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Abbas A Chamsuddin, M.D.

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1578539557
  NPD (past)
• Naiyer Imam, MD

  • Diagnostic Radiology Physician
  • Roanoke, VA
  • NPI 1992768147
  NPD (past)
• Jason Y Liu, MD.

  • Diagnostic Radiology Physician
  • Newport Beach, CA
  • NPI 1790725364
  NPD (past)
• Ashford McAllister, MD

  • Diagnostic Radiology Physician
  • Smyrna, GA
  • NPI 1659351666
  NPD (past)
• Derek Kurt Urban, MD

  • Diagnostic Radiology Physician
  • Lackland a F B, TX
  • NPI 1033197454
  NPD (past)
• Lloyd David Wagner, M.D.

  • Diagnostic Radiology Physician
  • Camden, NJ
  • NPI 1124161872
  NPD (past)
• John R Wohlwend, MD

  • Diagnostic Radiology Physician
  • Henderson, NV
  • NPI 1548297351
  NPD (past)

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1710145644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 PROFESSIONAL CT STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280835",
            "telephone_number": "702-839-1133",
            "fax_number": "866-274-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1564 N OVERLAND TRAILS DR",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "847802417",
            "telephone_number": "702-839-1133",
            "fax_number": "702-851-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY MEDICAL IMAGING OF UTAH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "FASELT",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-839-1133",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "UT",
            "license": "63916660161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104823368",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glen Porter, CMHC
• Kristin Porter, PHARM.D.
• Tracey Kathleen Porter, LCSW
• Praesidium, Inc.
• Premere Rehab LLC
• Quality Medical Imaging of Utah, Inc.
• Raymond K. Hinton M.D.P.C
• Eric Record
• Red Cliffs Eye Care, Inc.
• Red Desert Rehab and Fitness, LLC

• All providers in Washington, UT
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.