EAST SIDE IMAGING, LLC (NPI# 1316425432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316425432 |
| Entity Type | Organization |
| Organization Name | EAST SIDE IMAGING, LLC |
| Other Organization Name | OPEN IMAGING STATE |
| Practice Address |
3702 S State St Ste 111 Salt Lake City UT 84115-5078 |
| Mailing Address |
6243 S Redwood Rd Ste 130 Taylorsville UT 84123-6408 |
| Practice Telephone | 8012889671 |
| Practice Fax Number | 8012889583 |
| Mailing Telephone | 8012889671 |
| Mailing Fax Number | 8012889583 |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2018-07-31 |
| Authorized Official Name | ALBERT C. VAN KIRK (PRESIDENT AND CEO) |
| Authorized Official Telephone | 3306533968 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Open Imaging State | Doing Business As Name - Organization |
| Street Address |
3702 S STATE ST STE 111 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84115-5078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344198 | Shannon Ballinger | Clinic/Center | 1470 400 W, Salt Lake City, UT 84115 | 2020-10-22 |
| 1992346704 | Anicka Inc | Clinic/Center | 3195 South Main St, Ste 260, South Salt Lake, UT 84115 | 2019-10-02 |
| 1083177505 | Vitor Gabriel Giuliani Alcantara Carioca | Specialist/Technologist | 1850 South Campus Drive, Salt Lake City, UT 84115 | 2019-04-11 |
| 1427528371 | Samuel James Leonhart | Behavior Technician | 354 East Coatsville Drive, Salt Lake City, UT 84115 | 2018-12-04 |
| 1093228645 | Eco Pharmacy LLC | Pharmacy | 3702 S State Street Suite 115, South Salt Lake City, UT 84115 | 2017-11-06 |
| 1568973055 | Eco Apothecary LLC | Pharmacy | 3701 S State Street Suite 114, South Salt Lake City, UT 84115 | 2017-10-24 |
| 1548780455 | Kelly Lund | Case Manager/Care Coordinator | 447 W. Bearcat Dr., Salt Lake City, UT 84115 | 2017-06-21 |
| 1104271238 | The Church of Philadelphia Inc. | Community/Behavioral Health | 2358 South Main Street, Salt Lake City, UT 84115 | 2016-04-26 |
| 1710368626 | Jennifer Swanhild Edwards | Counselor | 140 W 2100 S Ste 244, Salt Lake City, UT 84115 | 2015-06-16 |
| 1508247065 | John Mcguire | Health Educator | 1370 S. West Temple, Salt Lake City, UT 84115 | 2015-06-10 |
| Find all providers in zip 84115 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407187701 | Monitoring Associates | Physiological Laboratory | 1817 W 800 N, Salt Lake City, UT 84025 | 2010-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740752500 | Stream Dx Inc | Physiological Laboratory | 2305 S 1070 W, West Valley City, UT 84119-1564 | 2018-12-18 |
| 1437671583 | Kg Medical Consulting | Physiological Laboratory | 231 E 200 N, American Fork, UT 84003-1742 | 2017-07-11 |
| 1639560154 | Elysium Labsource | Physiological Laboratory | 2435 W Spencer Crest Dr, Bluffdale, UT 84065-3048 | 2015-02-06 |
| 1194930495 | Brigham Young University | Physiological Laboratory | Y Be Fit, 127 Richards Building, Brigham Young University, Provo, UT 84602 | 2007-05-11 |
| 1235188608 | Diagnostic Health Corporation | Physiological Laboratory | 1850 Sidewinder Dr, Suite 410, Park City, UT 84060-7471 | 2006-05-10 |
| 1174526107 | Open Imaging Layton LLC | Physiological Laboratory | 2071 N Main St, Ste 100, Layton, UT 84041-4969 | 2005-05-23 |
| 1366445397 | Open Imaging Lc | Physiological Laboratory | 6243 S Redwood Rd, Ste 130, Taylorsville, UT 84123-6408 | 2005-05-23 |
| 1477921112 | Jml Lab Solutions | Physiological Laboratory | 10965 S State St, Sandy, UT 84070-4270 | 2015-09-11 |
| 1811374390 | Logan Sleep Diagnostics, Inc | Physiological Laboratory | 1395 N 400 E, Suite C, Logan, UT 84341-7530 | 2015-05-04 |
| 1447664552 | Schryver Medical Sales and Marketing, LLC | Physiological Laboratory | 9078 S 300 W, Sandy, UT 84070-2757 | 2014-06-17 |
| Find all providers with the same taxonomy | ||||
| City | SALT LAKE CITY |
| Zip Code | 84115 |
Please comment or provide details below to improve the information on EAST SIDE IMAGING, 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.