Quality Mobile Medical Imaging LLC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

License

452587 Issued in OK

Legal business name

QUALITY MOBILE MEDICAL IMAGING LLC

Practice address

802 SW Sandrock Rd
Bentonville, AR 72712-8227

Phone

(918) 851-8240

NPI assigned

May 7, 2014

Organization subpart

No

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

Authorized official

Name

Nabil Issouf Said KeitaNPI 1932406311

Title

Owner

Phone

(918) 851-8240

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Portable X-ray supplier certification: CCN 04X0009829

Legal name

QUALITY MOBILE MEDICAL IMAGING LLC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Oct 17, 2014

Last certification

Sep 18, 2014

Ownership / control type

INDIVIDUAL

Facility address

802 SW Sandrock Road
Bentonville, AR 72712

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nabil Issouf Said Keita, MS

  • Radiologic Technologist
  • Tulsa, OK
  • NPI 1932406311
  NPD Authorized official

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1851701106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 SW SANDROCK RD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128227",
            "telephone_number": "918-851-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 SW SANDROCK RD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128227",
            "telephone_number": "918-851-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY MOBILE MEDICAL IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-07",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "KEITA",
        "authorized_official_first_name": "NABIL",
        "authorized_official_middle_name": "ISSOUF SAID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-851-8240"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "OK",
            "license": "452587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Andre Pulliam, MHPP
• Surbhi Puri
• Logan Putnam, DMD
• QHG of Springdale Inc
• QHG of Springdale Inc
• Danielle A Quesnell, DPT
• Paige Juliane Quinlan
• Jack Mason Rader, DC
• Radiance Pediatric Therapy, LLC
• Cody Ragland, MHPP

• Mobile Radiology Clinic/Center in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Mobile Radiology Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.