MEDICARE: TARIN MATTHEW ARDMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471S1302X	Sonography Radiologic Technologist	131113	SD

General Provider Information

NPI Number	:	1801527619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARIN MATTHEW ARDMS

Provider Business Mailing Address
First Line	:	3645 STURGIS RD STE 200
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-0339
Country	:	US
Telephone Number	:	605-549-1621
Fax Number	:	605-205-2828

Provider Business Practice Location Address
First Line	:	3645 STURGIS RD STE 200
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-0339
Country	:	US
Telephone Number	:	605-549-1621
Fax Number	:	605-205-2828

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	07/16/2025

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