Active NPI
Stand-Up MRI of Arizona, LLC
- Radiology Clinic/Center
- Peoria, AZ
National Provider Identifier
1841380532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Clinic/Center
- Legal business name
- STAND-UP MRI OF ARIZONA, LLC
- Practice address
- 8581 W Kelton LN
Suite 202
Peoria, AZ 85382-4757 - Phone
- (623) 815-8500
- Fax
- (623) 815-7773
- NPI assigned
- Oct 13, 2006
- Last updated
- Aug 22, 2020
- 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
- David Longley
- Title
- Manager
- Phone
- (623) 815-8500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | NU | Primary |
Addresses
Primary practice location
8581 W Kelton LN
Suite 202
Peoria, AZ 85382-4757
Mailing address
8581 W Kelton LN
Suite 202
Peoria, AZ 85382-4757
Phone (623) 815-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 875693 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040525001087 | AZ | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 2668453804 | Practice locations: Peoria, AZ |
National Provider Directory
National Provider DirectoryLocations
8581 W Kelton Ln
Ste 202
Peoria, AZ 85382
Phone (623) 815-8500
Practitioners & affiliated clinicians
Practitioners 1
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
- Phoenix, AZ
- NPI 1730137464
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1841380532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8581 W KELTON LN",
"address_2": "SUITE 202",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853824757",
"telephone_number": "623-815-8500",
"fax_number": "623-815-7773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8581 W KELTON LN",
"address_2": "SUITE 202",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853824757",
"telephone_number": "623-815-8500",
"fax_number": "623-815-7773"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STAND-UP MRI OF ARIZONA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-13",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "LONGLEY",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "623-815-8500"
},
"taxonomies": [
{
"code": "261QR0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "875693",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, AZ
- St Therese Care LLC (St Therese Adult Care Home)
- St. Michael's Manor (TERESITA And MARIO CABACUNGAN)
- Kayla Marie Stacker, FNP
- Nicole S Stallworth
- Danika Marlynn Stampfel, M.S., CCC-SLP
- Trena Melee Stansberry, RN
- Samantha Grace Stapleton, SLP
- Star Clinic LLC
- Star Surgery Center, LLC
- Starlight Wellness LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.