NPIMap

Organization Active NPI

Women's Imaging Specialists - Norcross, LLC

  • Radiology Clinic/Center
  • Norcross, GA
National Provider Identifier
1053053652
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
WOMEN'S IMAGING SPECIALISTS - NORCROSS, LLC
Practice address
1235 Indian Trail Rd Ste 200
Norcross, GA 30093-5553
Phone
(866) 300-8512
Fax
(800) 889-0010
NPI assigned
Apr 13, 2022
Last updated
May 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Jennifer ReddyNPI 1407303332
Title
President / Owner
Phone
(866) 300-8512

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X NU Primary

Addresses

Primary practice location

1235 Indian Trail Rd Ste 200
Norcross, GA 30093-5553

Mailing address

3180 N Point Pkwy Ste 106
Alpharetta, GA 30005-4349
Phone (866) 300-8512

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220708003022 GA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1355721218 Practice locations: Norcross, GA

National Provider Directory

National Provider Directory

Locations

1235 Indian Trail Rd
Ste 200
Norcross, GA 30093
Phone (770) 931-1333

1235 Indian Trail Rd
Ste 200A
Norcross, GA 30093
Phone (239) 246-4314

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1053053652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 N POINT PKWY STE 106",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054349",
            "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": "1235 INDIAN TRAIL RD STE 200",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300935553",
            "telephone_number": "866-300-8512",
            "fax_number": "800-889-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMEN'S IMAGING SPECIALISTS - NORCROSS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-13",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "866-300-8512"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.