Active NPI
Marjorie Chinnock, ARRT
- Radiologic Technologist
- Polacca, AZ
National Provider Identifier
1891010807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- CRT - 12784
- Practice address
- M.P. 388 State Route 264
Polacca, AZ 86042-4000 - Phone
- (928) 737-6000
- Fax
- (928) 737-6069
- NPI assigned
- Apr 1, 2010
- Last updated
- Apr 1, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | CRT - 12784 | AZ | Primary |
Addresses
Primary practice location
M.P. 388 State Route 264
Polacca, AZ 86042-4000
Mailing address
PO Box 4000
Polacca, AZ 86042-4000
Phone (928) 737-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CRT - 12784 | AZ | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270080000000",
"number": "1891010807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4000",
"city": "POLACCA",
"state": "AZ",
"postal_code": "860424000",
"telephone_number": "928-737-6000",
"fax_number": "928-737-6069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "M.P. 388 STATE ROUTE 264",
"city": "POLACCA",
"state": "AZ",
"postal_code": "860424000",
"telephone_number": "928-737-6000",
"fax_number": "928-737-6069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHINNOCK",
"first_name": "MARJORIE",
"credential": "ARRT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-01",
"last_updated": "2010-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "AZ",
"license": "CRT - 12784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Polacca, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.