Samuel E Cordivin, R.T.

Primary specialty

Radiography Radiologic TechnologistTaxonomy code 2471C3402X

License

15727 Issued in AZ

Practice address

3480 E Route 66
Flagstaff, AZ 86004-4032

Phone

(928) 863-7333

NPI assigned

Jan 13, 2011

Last updated

Jan 13, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1770888281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 E SIOUX DR",
            "address_2": "11A",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860016668",
            "telephone_number": "928-640-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 E ROUTE 66",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860044032",
            "telephone_number": "928-863-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDIVIN",
        "first_name": "SAMUEL",
        "middle_name": "E",
        "credential": "R.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "AZ",
            "license": "15727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiography Radiologic Technologist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Radiography Radiologic Technologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.