Organization Active NPI

Wichita Area Mobile Service

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Wichita Falls, TX
National Provider Identifier
1891717799
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
License
45-X0009901 Issued in TX
Legal business name
WICHITA AREA MOBILE SERVICE
Practice address
2113 Kell Blvd Ste E
Wichita Falls, TX 76308-1256
Phone
(940) 761-2882
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Authorized official

Name
Mr. James E. Fancher
Title
Owner
Phone
(940) 761-2882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X 45-X0009901 TX Primary

Addresses

Primary practice location

2113 Kell Blvd Ste E
Wichita Falls, TX 76308-1256

Mailing address

2113 Kell Blvd Ste E
Wichita Falls, TX 76308-1256
Phone (940) 761-2882

Other identifiers 5

IdentifierTypeStateIssuer
45X0009901OtherTXPORT. XRAY MCR ID NO.
7102000TX76308OtherMIBCBS OF MICHIGAN
178472001MedicaidTX
00000MDXOOtherBCBS OF TEXAS
000009998OtherTXBCBS OF TEXAS PROVIDER NO

National Provider Directory

National Provider Directory

Locations

2113 Kell Blvd
Ste 4
Wichita Falls, TX 76308
Phone (940) 761-2882

2113 Kell Blvd
Ste E
Wichita Falls, TX 76308
Phone (940) 761-2882

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1891717799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2113 KELL BLVD STE E",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763081256",
            "telephone_number": "940-761-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2113 KELL BLVD STE E",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763081256",
            "telephone_number": "940-761-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA AREA MOBILE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "FANCHER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-761-2882",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "TX",
            "license": "45-X0009901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PORT. XRAY MCR ID NO.",
            "identifier": "45X0009901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "7102000TX76308",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178472001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "00000MDXO",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS PROVIDER NO",
            "identifier": "000009998",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.