OrganizationActive
Grand Canyon Medical Imaging LLC
NPI 1629109095 · Specialist · Kingman, AZ
Grand Canyon Medical Imaging LLC is a Specialist organization in Kingman, AZ (NPI 1629109095).
Provider details
- NPI number
- 1629109095
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- William Burge, Managing Partner(714) 754-5800
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(89/100 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
3269 Stockton Hill Rd
Kingman, AZ 86401-3619
Phone: (928) 757-0620
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 73878
San Clemente, CA 92673-0130
Registry dates
- Enumerated
- 2007-03-08
- Last updated
- 2007-07-12
Frequently asked questions
- What is Grand Canyon Medical Imaging LLC's NPI number?
- Grand Canyon Medical Imaging LLC's National Provider Identifier (NPI) is 1629109095, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Grand Canyon Medical Imaging LLC?
- Grand Canyon Medical Imaging LLC is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Grand Canyon Medical Imaging LLC located?
- Grand Canyon Medical Imaging LLC's practice location on file with NPPES is 3269 Stockton Hill Rd, Kingman, AZ 86401-3619.
- What is Grand Canyon Medical Imaging LLC's phone number?
- The practice phone number listed in the NPPES registry for Grand Canyon Medical Imaging LLC is (928) 757-0620.
- Who is the authorized official for Grand Canyon Medical Imaging LLC?
- The authorized official listed on Grand Canyon Medical Imaging LLC's NPPES record is William Burge, Managing Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Grand Canyon Medical Imaging LLC's NPI active?
- Yes — Grand Canyon Medical Imaging LLC's NPI (1629109095) is active in the NPPES registry as of the last update on 2007-07-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.