WHITE MOUNTAIN IMAGING, LLC (NPI# 1750368890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750368890 |
| Entity Type | Organization |
| Organization Name | WHITE MOUNTAIN IMAGING, LLC |
| Practice Address |
5448 Highway 260 Lakeside AZ 85929-5739 |
| Practice Telephone | 9285372077 |
| Practice Fax Number | 9285375282 |
| Mailing Telephone | 9285372077 |
| Mailing Fax Number | 9285375282 |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BRIAN HOEFLE (BOARD MEMBER) |
| Authorized Official Telephone | 9285372077 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471M1202X |
Radiologic Technologist Specialization: Magnetic Resonance Imaging |
OTC5724 | AZ | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 918972 | 05 |
| Street Address |
5448 HIGHWAY 260 |
| City | LAKESIDE |
| State | AZ |
| Zip Code | 85929-5739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942563465 | Jeffrey R Lesueur Md PC | Otolaryngology | 5448 Highway 260, Suite 140, Lakeside, AZ 85929-5739 | 2012-06-19 |
| 1336366335 | Jeffrey Rayne Lesueur | Otolaryngology | 5448 Highway 260, Suite 140, Lakeside, AZ 85929-5739 | 2007-04-19 |
| 1750352324 | Sunrise Ambulatory Surgical Center LLC | Clinic/Center | 5448 Highway 260, Suite 100, Lakeside, AZ 85929-5739 | 2006-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689272700 | Pediatric Multicare West, LLC | Pediatrics | 316 W. White Mountain Blvd., Suite A, Lakeside, AZ 85929 | 2020-10-12 |
| 1841836285 | Changepoint Integrated Health | Community/Behavioral Health | 1920 West Commerce Dr, Lakeside, AZ 85929 | 2019-11-20 |
| 1184111692 | Statclinix Plc | Clinic/Center | 3457 W White Mountain Blvd, Lakeside, AZ 85929 | 2018-04-19 |
| 1154827863 | Advanced Health and Wellness Az | Clinic/Center | 4830 Highway 260 Ste 102, Lakeside, AZ 85929 | 2018-04-02 |
| 1740648260 | Ries Chiropractic and Rehabilitation Center LLC | Point of Service | 5658 Hwy 260 Ste 1, Lakeside, AZ 85929 | 2016-01-29 |
| 1912395807 | Samuel Jesus Rosero Garcia | Family Medicine | 300 W. White Mountain Blvd, Suite D, Lakeside, AZ 85929 | 2014-12-31 |
| 1104178326 | Ronald T. Watanabe | Chiropractor | 20 West White Mountain Road, Safeway Pharmacy, Lakeside, AZ 85929 | 2012-10-11 |
| 1962705442 | San Tan Behavioral Health Services | Non-emergency Medical Transport (VAN) | 1277 Hummingbird Circle, Lakeside, AZ 85929 | 2010-12-06 |
| 1609181718 | Freter Family Practice Pllc | Family Medicine | 5448 S. White Mountain Blvd, 270, Lakeside, AZ 85929 | 2010-08-12 |
| 1760701221 | Sierra Blanca Rehabilitation LLC | Skilled Nursing Facility | 3401 N Lockwood Dr, Lakeside, AZ 85929 | 2010-05-24 |
| Find all providers in zip 85929 | ||||
| Taxonomy Code | 2471M1202X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Magnetic Resonance Imaging |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995569 | Westen Lemmon | Radiologic Technologist | 771 W Cool Dr, Tucson, AZ 85704-4613 | 2019-01-08 |
| 1972967438 | Medical Imagery Solutions & Staffing | Radiologic Technologist | 7415 W Boston St, Chandler, AZ 85226-3221 | 2016-04-11 |
| 1528376563 | Nephas Simudini | Radiologic Technologist | 7340 E Calle Merida, Tucson, AZ 85710-1415 | 2010-09-23 |
| 1275729964 | Christina Nicole Hayden | Radiologic Technologist | 3210 Fountain Palm Dr, Lake Havasu City, AZ 86404-2709 | 2007-09-17 |
| 1669905949 | James Carlyle | Radiologic Technologist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2017-04-04 |
| 1770820342 | Express Medical Imaging LLC | Radiologic Technologist | 5125 S Rural Rd, Tempe, AZ 85282-7008 | 2013-01-15 |
| 1710266697 | Beatrice Elizabeth Schneider | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2011-08-10 |
| 1194961300 | The Orthopedic Clinic Association PC | Radiologic Technologist | 2222 E Highland Ave, Suite 300, Phoenix, AZ 85016-4872 | 2008-12-18 |
| 1770784472 | Diana Marie Stager | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045 | 2007-05-30 |
| 1417002874 | Standup Mri of America IIi | Radiologic Technologist | 1110 E Missouri Ave, Suite 410, Phoenix, AZ 85014-2707 | 2007-01-24 |
| Find all providers with the same taxonomy | ||||
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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.