Tellica Imaging, LLC
NPI 1710605696 · Physiological Laboratory · Draper, UT
Enrolled with Medicare as Part B Supplier - Independent Diagnostic Testing Facility (idtf) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Tellica Imaging, LLC is a Physiological Laboratory organization in Draper, UT (NPI 1710605696).
Provider details
- NPI number
- 1710605696
- Entity type
- Organization
- Primary specialty
- Physiological LaboratoryLaboratories
- Parent organization
- Intermountain Healthcare
- Organization subpart
- Yes
- Authorized official
- Nannette Berensen, Ceo(801) 507-8002
Specialties & taxonomies
Laboratories
- Radiology Clinic/Center261QR0200X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
Mailing address
Registry dates
- Enumerated
- 2022-08-17
- Last updated
- 2023-02-07
- Certified
- 2023-02-07
Frequently asked questions
- What is Tellica Imaging, LLC's NPI number?
- Tellica Imaging, LLC's National Provider Identifier (NPI) is 1710605696, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Tellica Imaging, LLC?
- Tellica Imaging, LLC is classified in the NPPES registry as Physiological Laboratory (Laboratories).
- Where is Tellica Imaging, LLC located?
- Tellica Imaging, LLC's practice location on file with NPPES is 195 W 13290 S, Draper, UT 84020.
- What is Tellica Imaging, LLC's phone number?
- The practice phone number listed in the NPPES registry for Tellica Imaging, LLC is (801) 442-5737.
- Does Tellica Imaging, LLC accept Medicare?
- Tellica Imaging, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Tellica Imaging, LLC?
- The authorized official listed on Tellica Imaging, LLC's NPPES record is Nannette Berensen, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Tellica Imaging, LLC's NPI active?
- Yes — Tellica Imaging, LLC's NPI (1710605696) is active in the NPPES registry as of the last update on 2023-02-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.