Organization Active NPI

Wasatch Medical Imaging LLC

  • Radiology Clinic/Center
  • Heber, UT
National Provider Identifier
1841016672
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
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, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20250909003566 UT Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3971006776 Practice locations: Heber, UT

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.