| NPI | 1104014257 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2007-10-12 |
| Last Updated | 2012-12-19 |
| Authorized Official | Steven Walsh managing partner Phone: 5204595227 |
| Mailing Address | 155 Calle Portal Ste 500 Sierra Vista, AZ 85635-2973 United States Phone: (520) 459-5227 | Fax: (520) 459-2191 📍 View Map |
| Primary Practice Address | 155 Calle Portal Ste 500 Sierra Vista, AZ 85635-2973 United States Phone: (520) 459-5227 | Fax: (520) 459-2191 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | AZ | 220575001 | — |
| MEDICAID | AZ | 255085001 | — |
| Other (non-Medicare) | AZ | DD8752 | RAILROAD MEDICARE |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 2085R0202X – Radiology, Diagnostic Radiology | AZ | 9110 |
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About NPI 1104014257
Sierra Vista Diagnostics Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1104014257. The primary specialty listed is Radiology, Diagnostic Radiology. The organization is located in Sierra Vista, AZ. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-10-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1104014257?
NPI 1104014257 belongs to Sierra Vista Diagnostics Llc, a Radiology, Diagnostic Radiology in Sierra Vista, AZ. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1104014257 active?
The current status of NPI 1104014257 in the NPPES registry is Active. The record was last updated on 2012-12-19.
What specialty is NPI 1104014257?
NPI 1104014257 is classified under the taxonomy Radiology, Diagnostic Radiology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1104014257?
You can verify NPI 1104014257 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1104014257?
The primary practice address on file for NPI 1104014257 is 155 Calle Portal Ste 500, Sierra Vista, AZ 85635-2973. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1104014257 issued?
NPI 1104014257 was first issued (enumerated) on 2007-10-12. The NPPES record was last updated on 2012-12-19.
Practice Location Map
Sierra Vista Diagnostics Llc is located at 155 Calle Portal Ste 500, Sierra Vista, AZ. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Sierra Vista Diagnostics Llc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1104014257. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Radiology, Diagnostic Radiology | 9110 | AZ |