INTRAOPERATIVE NEUROLOGICAL MONITORING DIAGNOSTICS, LLC (NPI# 1043613987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043613987 |
Entity Type | Organization |
Organization Name | INTRAOPERATIVE NEUROLOGICAL MONITORING DIAGNOSTICS, LLC |
Other Organization Name | ION.MD |
Practice Address |
1990 Mcculloch Blvd N # D281 Lake Havasu City AZ 86403-5749 |
Practice Telephone | 2813245660 |
Practice Fax Number | 2813245679 |
Mailing Telephone | 2813245660 |
Mailing Fax Number | 2813245679 |
Enumeration Date | 2014-10-07 |
Last Update Date | 2014-10-07 |
Authorized Official Name | BRIAN CASTLE (PRESIDENT) |
Authorized Official Telephone | 2813245660 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
Other Name | Type Code |
---|---|
Ion.MD | Doing Business As Name - Organization |
Street Address |
1990 MCCULLOCH BLVD N # D281 |
City | LAKE HAVASU CITY |
State | AZ |
Zip Code | 86403-5749 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942606843 | Reflex Reading, LLC | Psychiatry & Neurology | 1990 Mcculloch Blvd N # D281, Lake Havasu City, AZ 86403-5749 | 2014-11-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
Find all providers in zip 86403 |
Taxonomy Code | 246ZE0600X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Specialist/Technologist, Other |
Specialization | Electroneurodiagnostic |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407202989 | Jeremy Burress | Specialist/Technologist, Other | 2451 Seabring Dr, Lake Havasu City, AZ 86403-3156 | 2016-05-13 |
1124429824 | Tyler Savage | Specialist/Technologist, Other | 3333 Chemehuevi Blvd, Lake Havasu City, AZ 86406-7143 | 2014-09-12 |
1316319460 | Sarah Fraser | Specialist/Technologist, Other | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2015-10-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720688294 | Kathy Hoang | Specialist/Technologist, Other | 2131 E Broadway Rd Ste 22, Tempe, AZ 85282-1737 | 2020-10-26 |
1609492743 | Alberto Aguilar Rodriguez | Specialist/Technologist, Other | 21012 S 194th St, Queen Creek, AZ 85142-8804 | 2020-06-24 |
1982199915 | Donna Lowe | Specialist/Technologist, Other | 5115 N Dysart Rd # 202-197, Litchfield Park, AZ 85340-3032 | 2018-06-22 |
1235665050 | Allegiant Diagnostics, LLC | Specialist/Technologist, Other | 15508 W Bell Rd Ste 101, Pmb #411, Surprise, AZ 85374-2432 | 2017-05-11 |
1366987265 | Jing Zhang | Specialist/Technologist, Other | 2301 E Sanoque Ct, Gilbert, AZ 85298-6124 | 2016-12-31 |
1093257305 | Meagan Re | Specialist/Technologist, Other | 3131 N 70th St, Scottsdale, AZ 85251-6383 | 2016-11-17 |
1699217919 | Christopher Townsend | Specialist/Technologist, Other | 7161 E Rancho Vista Dr, Unit 4005, Scottsdale, AZ 85251-1495 | 2016-11-17 |
1588112072 | Standard Iom, LLC | Specialist/Technologist, Other | 5115 N Dysart Rd Ste 202 #197, Litchfield Park, AZ 85340-3036 | 2016-09-14 |
1295283794 | Standard Monitoring LLC | Specialist/Technologist, Other | 5115 N Dysart Rd Ste 202 No 197, Litchfield Park, AZ 85340-3036 | 2016-09-14 |
1679920961 | Spine Ionm, LLC | Specialist/Technologist, Other | 8326 W Corrine Dr, Peoria, AZ 85381-5171 | 2016-05-17 |
Find all providers with the same taxonomy |
City | LAKE HAVASU CITY |
Zip Code | 86403 |
Please comment or provide details below to improve the information on INTRAOPERATIVE NEUROLOGICAL MONITORING DIAGNOSTICS, LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.