ELEVATION MEDICAL IMAGING EVANSTON LLC (NPI# 1184242521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1184242521 |
Entity Type | Organization |
Organization Name | ELEVATION MEDICAL IMAGING EVANSTON LLC |
Practice Address |
1535 South Hwy 150 Evantson WY 82931 |
Mailing Address |
Po Box 2393 Idaho Falls ID 83403-2393 |
Practice Telephone | 3076901523 |
Mailing Telephone | 8003385378 |
Mailing Fax Number | 2085238978 |
Enumeration Date | 2020-07-13 |
Last Update Date | 2020-09-25 |
Authorized Official Name | SHAUN ANDRIKOPOULOS (DIRECTOR OFFICER) |
Authorized Official Telephone | 3076901523 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities |
Street Address |
1535 SOUTH HWY 150 |
City | EVANTSON |
State | WY |
Zip Code | 82931 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083941389 | Todd Bader | Counselor | 724 Front St, Suite 511, Evanston, WY 82931 | 2009-11-06 |
1669564712 | Roger Nelson Scarborough | Counselor | 831 Highway 150 South, Evanston, WY 82931 | 2006-09-28 |
1598868689 | Mary Elizabeth Coffeen-carley | Nurse Practitioner | 831 St. Highway, 150 South, Wyoming State Hospital, Evanston, WY 82931 | 2006-09-06 |
1114387677 | Patricia Ann Roberts | Social Worker | 831 S Hwy 150, Evanston, WY 82931-0177 | 2016-02-26 |
1548389091 | Donald Roger Rardin | Psychologist | Highway 150 South, Evanston, WY 82931-0177 | 2007-03-28 |
1265479075 | Uinta Senior Citizens | Home Health | 1229 Uinta St, Evanston, WY 82931-0728 | 2006-06-01 |
1457358376 | Tender Heart Home Care Hospice | Case Management | 624 Twin Ridge, Evanston, WY 82931-2130 | 2005-07-07 |
1174805402 | High Country Behavioral Health | Clinic/Center | 190 Overthrust Rd., Evanston, WY 82931-2910 | 2011-09-13 |
Taxonomy Code | 261QM1200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Magnetic Resonance Imaging (MRI) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568721553 | Phi Health, LLC | Clinic/Center | 2405 E Grand Ave, Suite D, Box 136, Laramie, WY 82070-5206 | 2012-05-10 |
1124207345 | Fremont Radiology PC | Clinic/Center | 2102 W Sunset Dr, Riverton, WY 82501 | 2007-10-25 |
1366936270 | Casper Orthopedic Associates PC | Clinic/Center | 4140 Centennial Hills Blvd Ste A, Casper, WY 82609-3265 | 2018-06-15 |
1205165727 | Bone & Joint Radiology, LLC | Clinic/Center | 508 Stocktrail Ave, Suite A, Gillette, WY 82716-3582 | 2009-12-11 |
1154490233 | Teton Mri | Clinic/Center | 625 E Broadway, Jackson, WY 83001 | 2006-11-06 |
1477641272 | Wyoming Imaging Center | Clinic/Center | 231 S Washington St, Casper, WY 82601-2948 | 2006-10-10 |
Please comment or provide details below to improve the information on ELEVATION MEDICAL IMAGING EVANSTON 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.