Tellica Imaging, LLC is a Radiology Clinic/Center (organization) practicing in Manchester, New Hampshire. The National Provider Identifier (NPI) is #1457055774, which was assigned on March 29, 2023, and the registration record was last updated on August 27, 2025. The practitioner's main practice location is at 1100 Bicentennial Dr Ste 3b, Manchester, NH 03104-2173; the contact telephone number is 6032923491. The primary taxonomy of Tellica Imaging, LLC is Radiology Clinic/Center (261QR0200X), with specialization in Radiology. The authorized official for Tellica Imaging, LLC is Mark Vawdrey (Chief Financial Officer).
| NPI | 1457055774 |
| Entity Type | Organization |
| Organization Name | TELLICA IMAGING, LLC |
| Provider Name | TELLICA IMAGING, LLC |
| Practice Address |
1100 Bicentennial Dr Ste 3b Manchester NH 03104-2173 |
| Practice Telephone | 6032923491 |
| Mailing Address |
36 S State St Ste 2200 Salt Lake City UT 84111-1470 |
| Certification Date | 2025-08-27 |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2025-08-27 |
| Is Organization Subpart | Y |
| Parent Organization Legal Business Name | INTERMOUNTAIN HEALTHCARE |
| Official Name | MARK VAWDREY |
| Official Title | CHIEF FINANCIAL OFFICER |
| Telephone | 8017181642 |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| N | 2085R0202X | Radiology | Diagnostic Radiology | 193400000X SINGLE SPECIALTY GROUP | ||
| Y | 261QR0200X | Clinic/Center | Radiology |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Tellica Imaging, LLC | 692 East Market Place Drive, Spanish Fork, UT 84660 | Radiology Clinic/Center | 2024-03-22 |
| Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Grouping | Ambulatory Health Care Facilities |
| Definition: Definition to come... |
| Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| Grouping | Allopathic & Osteopathic Physicians |
| Definition: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
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|---|---|---|---|
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| American Health Imaging of South Carolina LLC | 2117 E. Main St., Spartanburg, SC 29307 | Radiology Clinic/Center | 2025-08-01 |
| American Health Network of Indiana LLC | 4101 Technology Ave, New Albany, IN 47150-8548 | Radiology Clinic/Center | 2025-07-25 |
| Midshore Imaging LLC | 4182 Osborne Rd, Hurlock, MD 21643-3000 | Radiology Clinic/Center | 2025-08-27 |
| Spartan Kismet LLC | 665 Martinsville Rd # 22b, Basking Ridge, NJ 07920-4700 | Radiology Clinic/Center | 2025-09-04 |
| Origin Diagnostics LLC | 17227 W Grand Pkwy S Ste B, Sugar Land, TX 77479-3689 | Radiology Clinic/Center | 2025-07-31 |
| See My Baby Live | 11183 Circle Dr Ste C, Austin, TX 78736-7785 | Radiology Clinic/Center | 2025-08-26 |
| Origin Diagnostics LLC | 19610 Tomball Pkwy Ste 300, Houston, TX 77070-6170 | Radiology Clinic/Center | 2025-07-31 |
| Jh Orthomri LLC | 1291 E Hillsdale Blvd Ste 143, Foster City, CA 94404-1293 | Radiology Clinic/Center | 2025-08-22 |
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| Street Address |
36 S STATE ST STE 2200 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84111-1470 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Kaye Salina Freeman · Gladys Kaye Meidinger | 36 S State St Ste 2200, Salt Lake City, UT 84111-1470 | Family Nurse Practitioner | 2008-07-30 |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Gabriella Gonzalez | 420 E South Temple Ste 410, Salt Lake City, UT 84111-1364 | Dentist | 2025-05-28 |
| Kobe Jeppesen | 275 E South Temple Ste 103, Salt Lake City, UT 84111-1323 | Clinical Social Worker | 2023-05-25 |
| Modern Dental Professionals - Utah, PC | 370 E South Temple Ste 350, Salt Lake City, UT 84111-1258 | Dentist | 2025-03-25 |
| Breanna Kathryn Kjar | 265 E 100 S Ste 250, Salt Lake City, UT 84111-1643 | Psychiatric/Mental Health Nurse Practitioner | 2025-07-23 |
| Anne Petersen | 370 E South Temple Ste 580, Salt Lake City, UT 84111-1349 | Clinical Social Worker | 2025-04-23 |
| Melissa Martinez | 370 E South Temple, Salt Lake City, UT 84111-1206 | Clinical Social Worker | 2024-11-25 |
| Julie A. Burton | 29 S State St Apt 712, Salt Lake City, UT 84111-1515 | Professional Counselor | 2006-08-31 |
| Lyly Gonoratskiy | 370 E South Temple Ste 580, Salt Lake City, UT 84111-1349 | Clinical Social Worker | 2025-07-02 |
| Modern Dental Professionals Utah PC | 420 E South Temple, Suite 312, Salt Lake City, UT 84111-1319 | General Practice Dentistry | 2006-12-08 |
| Christian Snuffer | 275 E South Temple Ste 250, Salt Lake City, UT 84111-1273 | Mental Health Counselor | 2019-11-08 |
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| Rm. Imaging, Inc. | 2499 Glades Rd Ste 206, Boca Raton, FL 33431-7201 | Cardiology Technician | 2005-08-02 |
| Insight Imaging, Inc | 2003a Whitesburg Dr S, Huntsville, AL 35801-4543 | Diagnostic Ultrasound Physician | 2006-05-02 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |