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SMI IMAGING LLC NPI 1568784353


NPI Information

NPI: 1568784353
Provider Name: SMI IMAGING, LLC

Other Name: SIMONMED IMAGING - STADIUM VILLAGE

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 03D2070257

Address:
14823 W BELL RD
SUITE 110
SURPRISE, AZ
ZIP 85374
Phone: (623) 214-1492
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SMI IMAGING, LLC is a diagnostic radiology radiology in Surprise, 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 1568784353. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Simonmed Imaging - Stadium Village.

The provider's business location address is:

14823 W BELL RD
SUITE 110
SURPRISE, AZ
ZIP 85374-607
Phone: (623) 214-1492
Fax: (623) 546-5783

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 03D2070257 - other - medical radiology 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
12085R0202XRadiologyDiagnostic RadiologyOTC4917ARIZONAYes

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
1571290MEDICAIDARIZONA
2Z143381MEDICARE PINARIZONA

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: 5/5/2024

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