417 SPORTS ADVANCED IMAGING LLC – NPI #1225906597
Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Health Care Provider Taxonomy Code for Radiology

417 SPORTS ADVANCED IMAGING LLC is a radiologist located in SPRINGFIELD, MO. NPPES has assigned the NPI number 1225906597 to 417 SPORTS ADVANCED IMAGING LLC on October 28, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2085R0202X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Diagnostic Radiology

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 417 SPORTS ADVANCED IMAGING LLC below.

NPI Profile for
417 SPORTS ADVANCED IMAGING LLC

NPI Number
1225906597
Enumeration Date

(about 7 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
417 SPORTS ADVANCED IMAGING LLC
Primary location
3328 S NATIONAL AVE
SPRINGFIELD, MO 65807-7305
Phone: (417) 771-3147 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
ERIC GIFFORD
OWNER
Phone: (417) 771-3147
Updated
Certification Date
Oct 28, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2085R0202X
- Radiology / Diagnostic Radiology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.