Organization Active NPI

Stand-Up MRI of Arizona, LLC

  • Radiology Clinic/Center
  • Peoria, AZ
National Provider Identifier
1841380532
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
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, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
875693MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525001087 AZ Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2668453804 Practice locations: Peoria, AZ

National Provider Directory

National Provider Directory

Locations

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.

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

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.

Verify at the official NPI Registry.