Organization Active NPI

Women'S Imaging Specialists - Dawsonville, LLC

  • Mammography Clinic/Center
  • Dawsonville, GA
National Provider Identifier
1013740364
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mammography Clinic/CenterTaxonomy code 261QR0206X
Legal business name
WOMEN'S IMAGING SPECIALISTS - DAWSONVILLE, LLC
Practice address
75 Elliott Rd Ste 210
Dawsonville, GA 30534-8904
Phone
(866) 300-8512
Fax
(800) 889-0010
NPI assigned
Aug 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Reddy
Title
Manager
Phone
(866) 300-8512

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mammography Clinic/Center 261QR0206X Primary

Addresses

Primary practice location

75 Elliott Rd Ste 210
Dawsonville, GA 30534-8904

Mailing address

5900 Windward Pkwy Ste 230
Alpharetta, GA 30005-8861
Phone (866) 300-8512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250602000855 GA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7618486762 Practice locations: Dawsonville, GA

National Provider Directory

National Provider Directory

Locations

75 Elliott Rd
Ste 210
Dawsonville, GA 30534

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1013740364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 WINDWARD PKWY STE 230",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300058861",
            "telephone_number": "866-300-8512",
            "fax_number": "800-613-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ELLIOTT RD STE 210",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305348904",
            "telephone_number": "866-300-8512",
            "fax_number": "800-889-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMEN'S IMAGING SPECIALISTS - DAWSONVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "866-300-8512"
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.