{"npi":"1740225531","type":"NPI-2","status":"active","name":{"display":"Medical Imaging Associates Of Idaho Falls, INC","other":[],"organization_name":"MEDICAL IMAGING ASSOCIATES OF IDAHO FALLS, INC","authorised_official":"Karen Vaughn"},"specialty":{"primary_taxonomy":"2085R0202X","primary_taxonomy_description":"Diagnostic Radiology","slug":"diagnostic-radiology","schema_org_specialty":"Radiography","all":[{"code":"2085R0204X","description":"Vascular & Interventional Radiology Physician","primary":false,"state":null,"license":null},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"777 HOSPITAL WAY","city":"POCATELLO","state":"ID","postal_code":"832015175","country_code":"US","phone":"2085296111"},{"purpose":"MAILING","street_1":"PO BOX 85495","city":"CHICAGO","state":"IL","postal_code":"606895495","country_code":"US","phone":"2087155220"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"002435500","state":"ID","issuer":null},{"type_code":"01","label":"Other","value":"CD9692","state":null,"issuer":"RAILROAD MEDICARE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20040108000883","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"ID","pac_id":"7618876590"},{"enrlmt_id":"O20081230000032","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"MT","pac_id":"7618876590"},{"enrlmt_id":"O20111018000597","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"WY","pac_id":"7618876590"},{"enrlmt_id":"O20190417002655","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"FL","pac_id":"7618876590"},{"enrlmt_id":"O20190426000006","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"IL","pac_id":"7618876590"},{"enrlmt_id":"O20190426000616","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"CO","pac_id":"7618876590"},{"enrlmt_id":"O20190501002326","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"AZ","pac_id":"7618876590"},{"enrlmt_id":"O20190501002619","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"WA","pac_id":"7618876590"},{"enrlmt_id":"O20190501002882","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"TX","pac_id":"7618876590"},{"enrlmt_id":"O20190501003286","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"UT","pac_id":"7618876590"},{"enrlmt_id":"O20190502001319","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"CA","pac_id":"7618876590"},{"enrlmt_id":"O20190508001985","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"DC","pac_id":"7618876590"},{"enrlmt_id":"O20190508002376","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"PA","pac_id":"7618876590"},{"enrlmt_id":"O20190514002572","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"NC","pac_id":"7618876590"},{"enrlmt_id":"O20190514002834","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"SC","pac_id":"7618876590"},{"enrlmt_id":"O20190517000336","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"KS","pac_id":"7618876590"},{"enrlmt_id":"O20190520003015","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"OH","pac_id":"7618876590"},{"enrlmt_id":"O20190530002710","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"WI","pac_id":"7618876590"},{"enrlmt_id":"O20200219001844","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"LA","pac_id":"7618876590"},{"enrlmt_id":"O20200414003966","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"OR","pac_id":"7618876590"},{"enrlmt_id":"O20210121003044","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"GA","pac_id":"7618876590"},{"enrlmt_id":"O20210217002283","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"VA","pac_id":"7618876590"},{"enrlmt_id":"O20210218000332","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"MA","pac_id":"7618876590"},{"enrlmt_id":"O20221103000225","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"MI","pac_id":"7618876590"},{"enrlmt_id":"O20221121002865","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"MD","pac_id":"7618876590"},{"enrlmt_id":"O20230523000998","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"IN","pac_id":"7618876590"},{"enrlmt_id":"O20240703000881","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"KY","pac_id":"7618876590"},{"enrlmt_id":"O20240819002038","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"TN","pac_id":"7618876590"}]},"enumeration_date":"2006-06-17","last_updated":"2026-03-25","_meta":{"source":"NPPES","snapshot_date":"2026-03-25","doc_url":"https://findmynpi.com/api"}}