SUN RADIOLOGY PC (NPI# 1124143011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124143011 |
| Entity Type | Organization |
| Organization Name | SUN RADIOLOGY PC |
| Practice Address |
13943 N 91st Ave Ste A102 Peoria AZ 85381 |
| Mailing Address |
13943 N 91st Ave Ste A102 Peoria AZ 85381-3688 |
| Practice Telephone | 6238158200 |
| Practice Fax Number | 6238158299 |
| Mailing Telephone | 6238152000 |
| Mailing Fax Number | 6238158299 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2019-10-23 |
| Authorized Official Name | MANNTEJ S SRA (CEO) |
| Authorized Official Telephone | 6027051353 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
28033 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 260762 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13090 N 94th Dr Ste 103, Peoria, AZ 853814257 | 6238158200 | 6238158299 |
| Street Address |
13943 N 91ST AVE STE A102 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801853890 | John Craig Farnham | Radiology | 13943 N 91st Ave Ste A102, Peoria, AZ 85381-3688 | 2006-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1932421591 | Smi Imaging, LLC | Radiology | 9125 W Thunderbird Rd, Suite 105, Peoria, AZ 85381-4920 | 2010-02-24 |
| 1972736163 | Smi Imaging, LLC | Radiology | 9403 W Thunderbird Rd, Peoria, AZ 85381-4825 | 2009-09-03 |
| 1184828360 | Jane Ho Maksimovic | Radiology | 2612 W Newman Pkwy, Peoria, IL 61604-2208 | 2007-06-12 |
| 1124030705 | Terry M Brady | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-08-12 |
| 1275543456 | Kim V. Arellano-villarreal | Radiology | 401 Sw Water St, Peoria, IL 61602-1571 | 2006-08-09 |
| 1386659241 | Central Illinois Radiological Associates, Ltd. | Radiology | Osf St Francis Medical Ctr, 530 N.e. Glen Oak, Peoria, IL 61636-0001 | 2006-07-29 |
| 1538192828 | Central Illinois Radiological Associates, Ltd. | Radiology | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2006-07-09 |
| 1265469399 | Brian A Holtan | Radiology | 31003 N 118th Ln, Peoria, AZ 85383-8240 | 2006-06-26 |
| Find all providers in PEORIA | ||||
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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.