Active NPI
Wasatch Medical Imaging LLC
- Radiology Clinic/Center
- Heber, UT
National Provider Identifier
1841016672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Clinic/Center
- Legal business name
- WASATCH MEDICAL IMAGING LLC
- Practice address
- 1776 North Highway 40
Suite 103
Heber, UT 84032-4148 - Phone
- (719) 650-4347
- Fax
- (801) 692-1873
- NPI assigned
- Nov 26, 2024
- Last updated
- Nov 26, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Brent K Ashby
- Title
- Manager/Owner
- Phone
- (719) 964-7813
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | Primary |
Addresses
Primary practice location
1776 North Highway 40
Suite 103
Heber, UT 84032-4148
Mailing address
1776 North Highway 40
Suite 103
Heber, UT 84032-4148
Phone (719) 650-4347
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250909003566 | UT | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 3971006776 | Practice locations: Heber, UT |
National Provider Directory
National Provider DirectoryLocations
1776 N Highway 40
Ste 103
Heber City, UT 84032
Phone (385) 433-3323
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Diagnostic Radiology Physician
- Farmington, UT
- NPI 1417154683
-
- Orthopaedic Surgery Physician
- Saratoga Springs, UT
- NPI 1942628300
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732579200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1732579200000",
"number": "1841016672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1776 NORTH HIGHWAY 40",
"address_2": "SUITE 103",
"city": "HEBER",
"state": "UT",
"postal_code": "840324148",
"telephone_number": "719-650-4347",
"fax_number": "801-692-1873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1776 NORTH HIGHWAY 40",
"address_2": "SUITE 103",
"city": "HEBER",
"state": "UT",
"postal_code": "840324148",
"telephone_number": "719-650-4347",
"fax_number": "801-692-1873"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WASATCH MEDICAL IMAGING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-11-26",
"last_updated": "2024-11-26",
"status": "A",
"authorized_official_last_name": "ASHBY",
"authorized_official_first_name": "BRENT",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "MANAGER/OWNER",
"authorized_official_telephone_number": "719-964-7813",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QR0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Heber, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.