OrganizationActive
Independent Imaging, LLC
NPI 1265583462 · Diagnostic Radiology Physician · Aurora, MO
Provider details
- NPI number
- 1265583462
- Entity type
- Organization
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Shore, President(314) 821-5600
- License
- LC0773278 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
500 Porter Ave
Aurora, MO 65605-2365
Phone: (417) 678-7880
Street-level locationGet directions
Mailing address
1715 Deer Tracks Trl
Saint Louis, MO 63131-1839
Registry dates
- Enumerated
- 2007-01-15
- Last updated
- 2008-04-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.