ARIZONA DIAGNOSTIC RADIOLOGY GROUP, LLC (NPI# 1336757699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336757699 |
| Entity Type | Organization |
| Organization Name | ARIZONA DIAGNOSTIC RADIOLOGY GROUP, LLC |
| Practice Address |
2653 W Guadalupe Rd Mesa AZ 85202-7200 |
| Mailing Address |
1160 Pittsford Victor Rd Ste D Pittsford NY 14534-3825 |
| Practice Telephone | 4804551860 |
| Mailing Telephone | 5852188019 |
| Mailing Fax Number | 5852188099 |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-07-22 |
| Authorized Official Name | NORMAN HAMES (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 3104452800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
2653 W GUADALUPE RD |
| City | MESA |
| State | AZ |
| Zip Code | 85202-7200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326006800 | Ronald C Petcher | Specialist | 2653 W Guadalupe Rd, Mesa, AZ 85202-7200 | 2006-05-03 |
| 1184916405 | Srigayatri D Bollepalli Nidamanuri | Radiology | 2653 W Guadalupe Rd, Aztech Radiology, Ste #100, Mesa, AZ 85202-7200 | 2011-05-04 |
| 1114175114 | Az-tech Radiology & Open Mri | Specialist | 2653 W Guadalupe Rd, Ste 100, Mesa, AZ 85202-7200 | 2008-09-03 |
| 1811037013 | Angela Marie Fried | Radiology | 2653 W Guadalupe Rd, Suite 100, Mesa, AZ 85202-7200 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275173536 | Samuel A Wolde | Counselor | Clear View Counseling, 2651 W Guadalupe Rd, Mesa, AZ 85202 | 2020-01-14 |
| 1912549171 | Lauren Barbara Loges | Occupational Therapist | 2225 E. Southern Avenue, Mesa, AZ 85202 | 2019-10-09 |
| 1245724822 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1450 S Dobson Rd Ste B326, Mesa, AZ 85202 | 2018-06-18 |
| 1457843310 | Jay Douglas Baumgardner | Physical Therapist | 1941 W. Guadalupe Rd. Suite 109, Mesa, AZ 85202 | 2018-06-05 |
| 1144746215 | Alyson Fix | Physician Assistant | 1432 S Dobson Rd Ste 304, Mesa, AZ 85202 | 2017-08-20 |
| 1194108852 | Robert Dale Labrum | Counselor | 1255 W Baseline Rd Ste B-258, Mesa, AZ 85202 | 2015-06-30 |
| 1114325677 | John David Shull Jr. | Physician Assistant | 1520 S Dobson Rd Ste 305, Mesa, AZ 85202 | 2014-12-16 |
| 1316356207 | Embry Womens Health LLC | Nurse Practitioner | 2204 S Dobson Road, Suite 203, Mesa, AZ 85202 | 2014-08-05 |
| 1619312899 | Fiza Naueed Khan | Internal Medicine | 1400 South Dobson Road, Attn: Bmg Hospitalists Team/amanda Gump, Mesa, AZ 85202 | 2013-05-01 |
| 1487903373 | Jodi Lynn Mealer | Pharmacist | 1951 W. Baseline Rd., Mesa, AZ 85202 | 2012-09-06 |
| Find all providers in zip 85202 | ||||
| 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 |
|---|---|---|---|---|
| 1225361454 | Smi Imaging, LLC | Radiology | 1425 S Greenfield Rd Bldg 2, Suite 114, Mesa, AZ 85206-5505 | 2009-09-04 |
| 1780817940 | Smi Imaging, LLC | Radiology | 1457 W Southern Ave Ste 26, Mesa, AZ 85202-4862 | 2009-09-03 |
| 1801029103 | Smi Imaging, LLC | Radiology | 130 S 63rd St Ste 123, Mesa, AZ 85206-1604 | 2009-09-02 |
| 1396701397 | Michelle Lee Dorsey | Radiology | 3850 E Huber St, Unit 1, Mesa, AZ 85205-3912 | 2006-04-26 |
| 1942285531 | Phoenix Diagnostic Imaging Inc | Radiology | 1111 S Dobson Rd, Mesa, AZ 85202-3902 | 2005-12-07 |
| 1306835020 | Karen B. Garby | Radiology | 1457 W Southern Ave, Suite 26, Mesa, AZ 85202-4813 | 2005-10-14 |
| 1861481731 | Monty D. Snow | Radiology | 1125 E Southern Ave, Suite 300, Mesa, AZ 85204-5045 | 2005-10-13 |
| 1609865559 | Joseph E. Wagner | Radiology | 6424 E Broadway Rd Ste 101, Mesa, AZ 85206-1750 | 2005-10-13 |
| 1063052793 | Steward Radiology Physicians of Arizona Inc | Radiology | 1301 S Crismon Rd, Mesa, AZ 85209-3767 | 2020-01-10 |
| 1316588072 | Desert Mobile Imaging LLC | Radiology | 8960 E Nora Cir, Mesa, AZ 85207-1441 | 2019-10-03 |
| Find all providers in MESA | ||||
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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.