PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC. (NPI# 1689813255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689813255 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC. |
| Other Organization Name | PROFESSIONAL PORTABLE X-RAY, INC. |
| Practice Address |
1551 Indian Hills Dr #104 Sioux City IA 51104-1859 |
| Mailing Address |
755 Cliff Rd E Burnsville MN 55337-1545 |
| Practice Telephone | 6123691991 |
| Practice Fax Number | 9528909025 |
| Mailing Telephone | 6123691991 |
| Mailing Fax Number | 9528909025 |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2016-05-12 |
| Authorized Official Name | MRS. SUZANNE MARIE MCNAMEE (PRESIDENT & CEO) |
| Authorized Official Telephone | 6123691991 |
| Authorized Official Credential | REGISTERED RT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | IA | Suppliers |
| Other Name | Type Code |
|---|---|
| Professional Portable X-ray, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285873810 | Professional Portable Radiologic Services, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 9132 West Cactus Rd, Suite D, Peoria, AZ 85381-5131 | 2009-02-04 |
| 1073560157 | Professional Portable Radiologic Services, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 755 Cliff Rd E, Burnsville, MN 55337-1545 | 2006-05-27 |
| 1154560373 | Professional Portable Radiologic Services, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 14301 Fnb Pkwy, Suite 100/182, Omaha, NE 68154-7200 | 2009-02-11 |
| 1013092196 | Professional Portable Radiologic Services, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 755 Cliff Rd E, Burnsville, MN 55337-1545 | 2006-10-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC. | 755 Cliff Rd E, Burnsville, MN 55337 |
| Street Address |
1551 INDIAN HILLS DR #104 |
| City | SIOUX CITY |
| State | IA |
| Zip Code | 51104-1859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063458636 | Carl Edwin Peters | Physician Assistant | 1551 Indian Hills Dr, Sioux City, IA 51104-1859 | 2006-06-21 |
| 1619456910 | Renee Ann Fagen | Psychologist | 1551 Indian Hills Dr, Sioux City, IA 51104-1859 | 2018-08-08 |
| 1922491638 | Simple Life, Inc. | Community/Behavioral Health | 1551 Indian Hills Dr, Suite 4, Sioux City, IA 51104-1859 | 2015-03-05 |
| 1144552068 | Northside Chiropractic Wellness Center Plc | Chiropractor | 1551 Indian Hills Dr, Suite 8, Sioux City, IA 51104-1859 | 2010-02-03 |
| 1174799225 | Michael P Baker Dba Associates for Psycholoigcal & Therapy Services | Counselor | 1551 Indian Hills Dr, Suite 221, Sioux City, IA 51104-1859 | 2008-05-07 |
| 1588705339 | Karen L Wall | Counselor | 1551 Indian Hills Dr, Suite 221, Sioux City, IA 51104-1859 | 2007-02-12 |
| 1114095403 | Indian Hills Pharmacy | Pharmacist | 1551 Indian Hills Dr, Ste 101, Sioux City, IA 51104-1859 | 2006-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578944435 | Family First Dental Associates of Iowa, P.C. | Dentist | 2100 Indian Hills Drive, Sioux City, IA 51104 | 2015-06-16 |
| 1740590785 | Khatu Vivienne Erlbacher | Pharmacist | 515 North Briar Path, Sioux City, IA 51104 | 2010-10-08 |
| 1730407545 | Randall Glen Wood | Emergency Medicine | 2720 Stone Park Blvd., Sioux City, IA 51104 | 2010-05-04 |
| 1790811024 | Fred R Rizk | Dentist | 1923 Nebraska Street, Siuox City, IA 51104 | 2007-02-23 |
| 1255474029 | Edilia Maria Marshall | Dentist | Summit Dental, 2114 Pierce St, Sioux City, IA 51104 | 2007-02-14 |
| 1063553410 | Thomas Leonard Tiedeman | Dentist | 2918 Hamilton Blvd, Upper D Suite 1, Sioux City, IA 51104 | 2007-02-09 |
| 1336209188 | Shawn Robert Walton | Dentist | 2410 Pierce Street, Sioux City, IA 51104 | 2006-12-11 |
| 1477649556 | Timothy R Kuntz | Dentist | 3012 Hamilton Blvd, Sioux City, IA 51104 | 2006-10-05 |
| 1528162732 | Duane Kent Nelson | Orthopaedic Surgery | 2800 Peirce St, Suite 101, Sioux City, IA 51104 | 2006-09-08 |
| 1659482206 | Shawn R Walton | Dentist | 2928 Hamilton Blvd, Suite 102, Sioux City, IA 51104 | 2006-08-31 |
| Find all providers in zip 51104 | ||||
| Taxonomy Code | 335V00000X |
| Grouping | Suppliers |
| Classification | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: title and definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841515335 | Firefly Imaging Services LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 222 Market St, Lake Park, IA 51347-7866 | 2010-03-29 |
| 1568456812 | Btx Iowa Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3160 8th St Sw Ste C, Altoona, IA 50009-1023 | 2005-09-01 |
| 1265085450 | Neurotech, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 117 Ne Trilein Dr Ste 202, Ankeny, IA 50021-2082 | 2019-07-17 |
| City | SIOUX CITY |
| Zip Code | 51104 |
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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.