NPIMap

Organization Active NPI

Idaho Medical Imaging, LLC

  • Diagnostic Radiology Physician
  • Pocatello, ID
National Provider Identifier
1770698482
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
IDAHO MEDICAL IMAGING, LLC
Practice address
444 Hospital Way Ste 611
Pocatello, ID 83201-2744
Phone
(208) 233-3000
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Scott Dean
Title
Business Manager
Phone
(208) 233-7931

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

444 Hospital Way Ste 611
Pocatello, ID 83201-2744

Mailing address

PO Box 2580
Pocatello, ID 83206-2580
Phone (208) 233-7931

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1770698482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832062580",
            "telephone_number": "208-233-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 HOSPITAL WAY STE 611",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012744",
            "telephone_number": "208-233-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO MEDICAL IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "208-233-7931"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.