NPIMap

Organization Active NPI

Professional Portable Radiologic Services Inc.

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • San Bernardino, CA
National Provider Identifier
1740867712
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
PROFESSIONAL PORTABLE RADIOLOGIC SERVICES INC.
Practice address
720 Carnegie Dr Ste 140
San Bernardino, CA 92408-3516
Phone
(866) 895-2119
Fax
(952) 890-9025
NPI assigned
Mar 25, 2021
Last updated
Mar 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Authorized official

Name
Bruce Allen Johnson
Title
VP-Ao
Phone
(303) 589-4149

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X NU Primary

Addresses

Primary practice location

720 Carnegie Dr Ste 140
San Bernardino, CA 92408-3516

Mailing address

755 Cliff Rd E
Burnsville, MN 55337-1545
Phone (866) 895-2119

Other names 2

  • PPX Other name
  • Professional Portable X-ray Other name

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

720 Carnegie Dr
Ste 140
San Bernardino, CA 92408

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743379200000",
    "number": "1740867712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 CLIFF RD E",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371545",
            "telephone_number": "866-895-2119",
            "fax_number": "952-890-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 CARNEGIE DR STE 140",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083516",
            "telephone_number": "866-895-2119",
            "fax_number": "952-890-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PORTABLE RADIOLOGIC SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-25",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "VP-AO",
        "authorized_official_telephone_number": "303-589-4149"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PPX",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Professional Portable X-ray",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.