PORTABLE DIAGNOSTIC IMAGING, INC. (NPI# 1568604585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568604585 |
| Entity Type | Organization |
| Organization Name | PORTABLE DIAGNOSTIC IMAGING, INC. |
| Other Organization Name | PREMIER PORTABLE X-RAY, INC. |
| Practice Address |
6545 France Ave S Suite C 62a Edina MN 55435-2131 |
| Practice Telephone | 6514701815 |
| Mailing Telephone | 6123694775 |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2009-04-06 |
| Authorized Official Name | MR. JAMES MICHAEL MCNAMEE (CEO) |
| Authorized Official Telephone | 6514701815 |
| 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 | MN | Suppliers |
| Other Name | Type Code |
|---|---|
| Premier Portable X-ray, Inc. | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447493390 | Portable Diagnostic Imaging, Inc. | Clinic/Center | 6545 France Ave S, Suite C 62a, Edina, MN 55435-2131 | 2009-04-08 |
| Street Address |
6545 FRANCE AVE S SUITE C 62A |
| City | EDINA |
| State | MN |
| Zip Code | 55435-2131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578569042 | Paul S. Gotlieb | Internal Medicine | 6545 France Ave S, Suite 150, Edina, MN 55435-2131 | 2005-06-21 |
| 1972111003 | Alexandra Michele Vecchia | Pharmacist | 6545 France Ave S, Edina, MN 55435-2131 | 2020-07-15 |
| 1144879396 | Sarah Pupkes Clark | Pharmacist | 6545 France Ave S, Edina, MN 55435-2131 | 2019-09-10 |
| 1043793144 | Stephanie Lynae Gulbranson | Nurse Practitioner | 6545 France Ave S, Edina, MN 55435-2131 | 2018-09-13 |
| 1366940850 | Elise Graham | Dietitian, Registered | 6545 France Ave S, Edina, MN 55435-2131 | 2018-01-30 |
| 1255877031 | Jami Teresa Weiss | Physician Assistant | 6545 France Ave S, 450, Edina, MN 55435-2131 | 2017-01-17 |
| 1952847741 | Kc Core Mn Pllc | Chiropractor | 6545 France Ave S, Suite 301, Edina, MN 55435-2131 | 2017-01-17 |
| 1255881967 | Dawn Hostenske Tope | Nurse Practitioner | 6545 France Ave S, Suite 564, Edina, MN 55435-2131 | 2016-10-05 |
| 1366894180 | Angela Yarbrough | Pharmacist | 6545 France Ave S, Edina, MN 55435-2131 | 2016-07-05 |
| 1467842419 | Steven Pals | Nurse Practitioner | 6545 France Ave S, Suite 450, Edina, MN 55435-2131 | 2015-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| 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 |
|---|---|---|---|---|
| 1881038263 | Health Diagnostics Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22841 Zion Pkwy Nw, Bethel, MN 55005-9315 | 2013-04-29 |
| 1750533469 | Premier Diagnostic Imaging, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 12800 Highway 55, Plymouth, MN 55441-3840 | 2008-10-14 |
| 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 |
| 1215499553 | North Star Mobile X-ray LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 6300 Shingle Creek Pkwy Ste 135, Minneapolis, MN 55430-2124 | 2019-04-04 |
| 1801130158 | Minnesota Medical Imaging, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 715 Florida Ave S, Suite 205, Golden Valley, MN 55426-1719 | 2012-11-26 |
| 1366747040 | Professional Portable Radiologic Service, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 4801 W 81st St, Bloomington, MN 55437-1111 | 2011-01-11 |
| 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 |
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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.