HERITAGE IMAGING, INC. (NPI# 1548879943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548879943 |
| Entity Type | Organization |
| Organization Name | HERITAGE IMAGING, INC. |
| Practice Address |
12554 W. Bridger St. Suite 118 Boise ID 83713-1582 |
| Practice Telephone | 2089477000 |
| Practice Fax Number | 2089476942 |
| Mailing Telephone | 2089477000 |
| Mailing Fax Number | 2089476942 |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-07-31 |
| Authorized Official Name | MS. DEBRA KAYE EWAN (ADMINISTRATOR) |
| Authorized Official Telephone | 2089477000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0208X |
Clinic/Center Specialization: Radiology, Mobile |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| MRI Mobile | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | HERITAGE IMAGING, INC. | 41398 Old Hwy 30, Baker City, OR 97814 |
| Washington State Corporations | HERITAGE IMAGING, INC. | 6225 N Meeker Place Suite 210, Boise, ID 83713 |
| Street Address |
12554 W. BRIDGER ST. SUITE 118 |
| City | BOISE |
| State | ID |
| Zip Code | 83713-1582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
| 1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
| 1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
| 1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
| Find all providers in zip 83713 | ||||
| Taxonomy Code | 261QR0208X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588634356 | Portable Xray of Idaho LLC | Clinic/Center | 2399 S Orchard St, Boise, ID 83705-3793 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104225531 | Allied Portable X-ray Inc | Clinic/Center | 1255 Filer Ave E Ste C, Twin Falls, ID 83301-4118 | 2014-08-21 |
| 1730445214 | Onsite Diagnostic Solutions | Clinic/Center | 9133 N Orange Blossom Ct, Hayden, ID 83835-8748 | 2012-04-09 |
| 1730408170 | Alliance Healthcare Services Inc | Clinic/Center | 1702 16th St, Lewiston, ID 83501-3911 | 2010-05-25 |
| 1023028529 | Alliance Healthcare Services Inc | Clinic/Center | 1300 E Mullan Ave # 700, Post Falls, ID 83854-6052 | 2006-08-08 |
| 1508875360 | Diagnostic Imaging Service of Idaho | Clinic/Center | 1951 Bench Rd, Suite F, Pocatello, ID 83201-2073 | 2006-08-07 |
| 1255345765 | Idaho Independent Mri LLC | Clinic/Center | 562 Shoup Ave W, Twin Falls, ID 83301-5029 | 2006-07-28 |
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| 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.