PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC. (NPI# 1154560373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154560373 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC. |
| Other Organization Name | PROFESSIONAL PORTABLE X-RAY, INC. |
| Practice Address |
14301 Fnb Pkwy Suite 100/182 Omaha NE 68154-7200 |
| Mailing Address |
755 Cliff Rd E Burnsville MN 55337-1545 |
| Practice Telephone | 8668952119 |
| Practice Fax Number | 9528909025 |
| Mailing Telephone | 8668952119 |
| Mailing Fax Number | 9528909025 |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2016-05-12 |
| Authorized Official Name | MRS. SUZANNE MARIE MCNAMEE (PRINCIPAL, PRESIDENT & CEO) |
| Authorized Official Telephone | 6123691991 |
| Authorized Official Credential | 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 | 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 |
| 1689813255 | Professional Portable Radiologic Services, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1551 Indian Hills Dr, #104, Sioux City, IA 51104-1859 | 2009-02-05 |
| 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 |
14301 FNB PKWY SUITE 100/182 |
| City | OMAHA |
| State | NE |
| Zip Code | 68154-7200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538250097 | Aimee Renae Brown | Pharmacist | 14301 Fnb Pkwy, Suite 200, Omaha, NE 68154-5213 | 2006-09-27 |
| 1831577246 | Reanna Potter | Home Health | 14301 Fnb Pkwy, Suite 100, Omaha, NE 68154-7200 | 2015-05-18 |
| 1215141700 | Leandro Sapanlay Anit Jr. | Psychiatry & Neurology | 14301 Fnb Pkwy, Suite 100, Omaha, NE 68154-7200 | 2007-05-10 |
| 1912048091 | Todd Barret Moran | Pharmacist | 14301 Fnb Pkwy, Suite 200, Omaha, NE 68154-5213 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275149262 | Vervech | Counselor | 11422 Miracle Hills Drive, Suite 401, Omaha, NE 68154 | 2020-09-16 |
| 1891318150 | Pure Massage, LLC | Massage Therapist | Pure Massage, LLC, 11316 Davenport St, Omaha, NE 68154 | 2020-05-21 |
| 1326682592 | Andrea Dawn Degner | Counselor | 11580 W. Dodge Frontage Rd, Omaha, NE 68154 | 2019-10-31 |
| 1669035150 | Gerard Thomas IIi | Physical Therapist | Triage LLC, 12020 Pacific Street, Omaha, NE 68154 | 2019-04-19 |
| 1306311352 | Sakrx, LLC | Pharmacy | 624 N 114th St, Omaha, NE 68154 | 2018-10-05 |
| 1033622782 | Raquelle G. Rowe | Registered Nurse | 11840 Nicholas Street Suite 215, Med Staff, Omaha, NE 68154 | 2017-11-15 |
| 1336680396 | Kristi Bose | Nurse Practitioner | 11422 Miracle Hills Dr Ste 401, Omaha, NE 68154 | 2017-03-10 |
| 1326442781 | Heather Andsager | Pharmacy Technician | 13360 California Street, Omaha, NE 68154 | 2014-10-14 |
| 1073917605 | Ann Leever | Pharmacist | 505 N 155th Plaza, Omaha, NE 68154 | 2014-10-10 |
| 1689078222 | Melissa Svec | Emergency Medical Technician, Basic | 1705 N 121st St #203, Omaha, NE 68154 | 2014-10-10 |
| Find all providers in zip 68154 | ||||
| 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 |
|---|---|---|---|---|
| 1841653524 | Sonotech Imaging, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 17330 W Center Rd Ste 110-315, Omaha, NE 68130-2392 | 2016-03-31 |
| 1427395086 | Premier Mobile Imaging LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 101 N 38th Ave, Omaha, NE 68131-2301 | 2013-01-15 |
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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.