SMI IMAGING LLC NPI 1124340013

NPI Information

NPI: 1124340013
Provider Name: SMI IMAGING, LLC

Other Name: SIMONMED IMAGING - PRESCOTT VALLEY

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
3033 N WINDSONG DR
SUITE 102
PRESCOTT VALLEY, AZ
ZIP 86314
Phone: (928) 772-5250
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SMI IMAGING, LLC is a diagnostic radiology radiology in Prescott Valley, AZ. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. SMI IMAGING, LLC NPI is 1124340013. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Simonmed Imaging - Prescott Valley.

The provider's business location address is:

3033 N WINDSONG DR
SUITE 102
PRESCOTT VALLEY, AZ
ZIP 86314-290
Phone: (928) 772-5250
Fax: (928) 775-5728

The provider's authorized official is Howard J Simon .
The authorized official title is President and has the following contact phone number (480) 264-2400.

The CLIA number assigned to this NPI record is 03D1098121 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/19/2010 and was last updated on 3/30/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	OTC4919	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	566316	MEDICAID	ARIZONA
2	Z143396	MEDICARE PIN	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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