PROFESSIONAL PORTABLE RADIOLOGIC SERVICES INC. (NPI# 1598056384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598056384 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL PORTABLE RADIOLOGIC SERVICES INC. |
| Other Organization Name | PROFESSIONAL PORTABLE X-RAY, INC. |
| Practice Address |
2111 Main Ave E Unit A15 West Fargo ND 58078-2216 |
| Mailing Address |
755 Cliff Rd E Burnsville MN 55337-1545 |
| Practice Telephone | 8668952119 |
| Practice Fax Number | 9528909025 |
| Mailing Telephone | 6123691991 |
| Mailing Fax Number | 9528909025 |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2017-02-15 |
| Authorized Official Name | MRS. SUZANNE M MCNAMEE (PRINCIPAL AGENT/PRESIDENT & CEO) |
| Authorized Official Telephone | 6123691991 |
| 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 | ND | Suppliers |
| Other Name | Type Code |
|---|---|
| Professional Portable X-ray, Inc. | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679864458 | Professional Portable Radiologic Services Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 27057 Sunrise Ave., Unit A1, Sioux Falls, SD 57106-5915 | 2011-04-27 |
| Street Address |
2111 MAIN AVE E UNIT A15 |
| City | WEST FARGO |
| State | ND |
| Zip Code | 58078-2216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205068 | Ashley Kasson Therapy | Counselor | 3220 4th St E, West Fargo, ND 58078 | 2020-11-04 |
| 1427658624 | Deedee (dorin) Ngwe | Technician | 3240 9th S West Apt. 204, West Fargo, ND 58078 | 2020-10-27 |
| 1053879734 | Mpnd,inc | Pharmacy | 2050 Sheyenne Street, West Fargo, ND 58078 | 2019-03-12 |
| 1396239216 | Luke Gable | Behavior Technician | 647 13th Avenue South, West Fargo, ND 58078 | 2018-06-15 |
| 1629597919 | Cody Freng | Specialist/Technologist | 3276 9th St W Apt C, West Fargo, ND 58078 | 2017-09-18 |
| 1831613942 | Lauren Phyllis Loe | Physical Therapist | 1401 13th Avenue East, Essentia Health West Fargo Clinic, West Fargo, ND 58078 | 2017-07-31 |
| 1851746226 | Jodi Kilen | Occupational Therapy Assistant | 631 4th Ave East, West Fargo, ND 58078 | 2016-05-04 |
| 1922490101 | Betty Ann Helmer | Social Worker | 2355 Meadow Ridge Parkway, West Fargo, ND 58078 | 2015-02-25 |
| 1477972784 | Tessa Nicole Larson | Occupational Therapist | 3139 Bluestem Dr Ste 108, West Fargo, ND 58078 | 2014-04-15 |
| 1023432010 | Kaylyn Kortes | Licensed Practical Nurse | 1302 Sheyenne St, West Fargo, ND 58078 | 2014-02-11 |
| Find all providers in zip 58078 | ||||
| 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 |
|---|---|---|---|---|
| 1932158524 | Dms Imaging Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-05-09 |
| 1629636204 | Trinity Health | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1 Burdick Expy W, Minot, ND 58701-4406 | 2019-05-30 |
| 1104481779 | Trinity Hospitals | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 305 8th Ave Ne, Minot, ND 58703-2624 | 2019-05-08 |
| 1881899649 | Dms Imaging Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2101 University Dr N, Fargo, ND 58102-1816 | 2007-06-20 |
| 1538372206 | Dms Imaging Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2101 University Dr N, Fargo, ND 58102-1816 | 2007-05-08 |
| 1619922390 | Dms Imaging Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-05-23 |
| 1184674913 | Dms Imaging Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-05-11 |
| 1265482004 | Dms Imaging Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-05-11 |
| 1174573919 | Dms Imaging Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2101 University Dr N, Fargo, ND 58102-1816 | 2006-05-11 |
| City | WEST FARGO |
| Zip Code | 58078 |
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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.