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RADIANT ADULT MEDICAL GROUP
NPI 1255976403
Nurse Practitioner - Family in Yuma, AZ

Active since November 12, 2019CLIA 03D2287482 · Waiver
1025 W 24TH ST STE 26, YUMA, AZ 85364(928) 318-6910(928) 328-1056 Get Directions Write a Review

NPPES record last updated: September 13, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 13, 2024, Nov 8, 2023, Nov 12, 2019 (3 updates tracked since 2019).

About Radiant Adult Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RADIANT ADULT MEDICAL GROUP (NPI 1255976403) is a healthcare organization registered as a family in Yuma, Arizona and active in the NPI registry since November 2019. The organization holds a CLIA Waiver certificate valid through August 14, 2027 and lists Jennivyr Derakhshan, President, as its authorized official.

NPPES Registry Identity

NPI1255976403
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameBJD INC
Location Address1025 W 24TH ST STE 26Yuma, AZ 85364-8372
Mailing Address1025 W 24th St Ste 26Yuma, AZ 85364-8372 · (928) 318-6910 · Fax (928) 328-1056
Phone(928) 318-6910
Fax(928) 328-1056
Organization SubpartNo
Authorized OfficialJennivyr DerakhshanPresident · (928) 483-9911
Enumeration DateNovember 12, 2019
Last NPPES UpdateSeptember 13, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2024
✔ NPI 1255976403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
1025 W 24TH ST STE 26, Yuma, AZ 85364
Open in Google Maps ↗

Other Names 1

Doing Business AsRadiant Adult Medical Group

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2287482

Radiant Adult Medical Group · Yuma, AZ
Active · expires Aug 14, 2027
CLIA Number03D2287482
Laboratory TypePhysician Office
Certificate Effective DateAugust 15, 2025
Certificate Expiration DateAugust 14, 2027
Laboratory DirectorDavid J. Atondo
Laboratory Phone(928) 318-6910
Laboratory LocationRadiant Adult Medical Group1025 W 24th St Ste 26, Yuma, AZ 85364
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID J ATONDO FNP
Nurse Practitioner (Family)
1025 W 24TH ST STE 26
YUMA, AZ 85364
Yuma County (928) 318-6910
ALEJANDRA ESTRELLA VASQUEZ NP
Nurse Practitioner (Family)
1025 W 24TH ST STE 26
YUMA, AZ 85364
Yuma County (928) 318-6910
MR. FRANCISCO URBINA PA-C
Physician Assistant
1025 W 24TH ST STE 26
YUMA, AZ 85364
Yuma County (520) 886-7246
CHRISTAL L OTT FNP
Nurse Practitioner (Family)
1025 W 24TH ST STE 26
YUMA, AZ 85364
Yuma County (928) 318-6910

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bjd Inc's NPI number?

The NPI number for Bjd Inc is 1255976403. It was assigned to this organization in the NPPES registry on November 12, 2019. The provider is doing business as Radiant Adult Medical Group.

Where is Bjd Inc located?

Bjd Inc is located at 1025 W 24th St Ste 26, Yuma, AZ 85364. The listed phone number is (928) 318-6910.

What is Bjd Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Bjd Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2287482) is associated with this NPI, valid through August 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bjd Inc was last updated on September 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.