ARIZONA INTERVENTIONAL MEDICAL GROUP PC (NPI# 1053615021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053615021 |
| Entity Type | Organization |
| Organization Name | ARIZONA INTERVENTIONAL MEDICAL GROUP PC |
| Practice Address |
2338 W Royal Palm Rd Suite J Phoenix AZ 85021-9339 |
| Mailing Address |
1901 Butterfield Rd 220 Downers Grove IL 60515-7915 |
| Practice Telephone | 6307252768 |
| Practice Fax Number | 8772194810 |
| Mailing Telephone | 6307252768 |
| Mailing Fax Number | 8772194810 |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2011-01-05 |
| Authorized Official Name | J THEODORE KING (OWNER) |
| Authorized Official Telephone | 6307252768 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
42646 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
2338 W ROYAL PALM RD SUITE J |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85021-9339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659404176 | Portable X Ray of Arizona LLC | Radiology | 2338 W Royal Palm Rd, Phoenix, AZ 85021-9339 | 2007-03-13 |
| 1215187570 | Portable Imaging of Arizona, LLC | Clinic/Center | 2338 W Royal Palm Rd, Suite A, Phoenix, AZ 85021-9339 | 2008-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173181 | Jill M Robinson | Social Worker | 8804 N. 23rd Ave, Bldg. A Ste. A01-a02, Phoenix, AZ 85021 | 2020-10-26 |
| 1528671013 | Sabrina Mcninch | Behavior Technician | 1200 W Dunlap Ave, Ste 100, Phoenix, AZ 85021 | 2020-08-25 |
| 1376169938 | Maricopa County Special Heallth Care District | Pharmacy | 2025 W Northern Ave, Phoenix, AZ 85021 | 2020-06-19 |
| 1841832664 | Madison Westby | Physical Therapist | 717 W Dunlap Ave # 100, Phoenix, AZ 85021 | 2019-10-14 |
| 1861967481 | Southwest Family Naturopathic Clinic Pllc | Naturopath | 1530 W Glendale Ave Suite 103, Phoenix, AZ 85021 | 2018-10-10 |
| 1184101461 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 8804 N 23rd Ave, Suite A01/a02, Phoenix, AZ 85021 | 2018-07-19 |
| 1568970150 | Alycia Ann Poloni | Occupational Therapist | 7129 N 23d Ave, Phoenix, AZ 85021 | 2018-01-17 |
| 1154839165 | Cyrus Professional Corporation | Dentist | 2401 W. Glendale Ave, Ste 102, Phoenix, AZ 85021 | 2018-01-12 |
| 1568980779 | Marla Jean Clay | Licensed Practical Nurse | 1717 W. Glendale Ave. Apt. 3011, Phoenix, AZ 85021 | 2017-09-07 |
| 1801325162 | Kaitlin King | Nurse Practitioner | 8824 N 9th Ave, Phoenix, AZ 85021 | 2017-06-08 |
| Find all providers in zip 85021 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629242425 | Nelson R. De Lara | Radiology | 26 Glen Alpine Rd, Phoenix, MD 21131-2404 | 2008-04-14 |
| 1013387208 | Compcare Medical Group Inc | Radiology | 1021 S 7th Ave, Suite 102, Phoenix, AZ 85007-3725 | 2015-09-30 |
| 1669737714 | Ankit Harish Shah | Radiology | 2601 E Roosevelt St, Phoenix, AZ 85008 | 2012-07-05 |
| 1679835128 | Curtis Qin | Radiology | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2012-06-11 |
| 1093954554 | Vineel Kurli | Radiology | 10835 N 25th Ave, Suite 240, Phoenix, AZ 85029-4751 | 2009-02-06 |
| 1144482886 | Ahi Cardiovascular Surgeons Ltd | Radiology | 2632 N 20th St, Phoenix, AZ 85006-1339 | 2008-06-25 |
| 1104009109 | Interventional Radiology Plc | Radiology | 1800 E Van Buren St, Phoenix, AZ 85006-3742 | 2007-12-12 |
| 1235335324 | Lavi Nissim | Radiology | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2007-06-25 |
| 1427259555 | Grace Knuttinen | Radiology | 5777 E Mayo Blvd, Phoenix, AZ 85054 | 2007-05-29 |
| 1851427512 | Patricia E Thorpe | Radiology | 1930 E Thomas Rd, Phoenix, AZ 85016-7711 | 2007-02-26 |
| Find all providers in PHOENIX | ||||
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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.