Organization Active NPI

Atlanta VA Medical Center

  • Computed Tomography Radiologic Technologist
  • Detroit, MI
National Provider Identifier
1063288702
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Computed Tomography Radiologic TechnologistTaxonomy code 2471C3401X
Legal business name
ATLANTA VA MEDICAL CENTER
Practice address
7709 Lamphere
Detroit, MI 48239-1082
Phone
(313) 300-9541
NPI assigned
Dec 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Sherry Lynn Williams, RT(R)CT
Title
Cat Scan Technician
Phone
(313) 300-9541

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular-Interventional Technology Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471C1101X
Computed Tomography Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471C3401X Primary
Radiography Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471C3402X
Vascular-Interventional Technology Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471V0106X

Addresses

Primary practice location

7709 Lamphere
Detroit, MI 48239-1082

Mailing address

7709 Lamphere
Detroit, MI 48239-1082
Phone (313) 300-9541

Other practice location 1

1670 Clairmont Rd
Decatur, GA 30033-4004
Phone (404) 321-6111

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1063288702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7709 LAMPHERE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482391082",
            "telephone_number": "313-300-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7709 LAMPHERE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482391082",
            "telephone_number": "313-300-9541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 Clairmont Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300334004",
            "country_code": "US",
            "telephone_number": "404-321-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ATLANTA VA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-02",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CAT SCAN TECHNICIAN",
        "authorized_official_telephone_number": "313-300-9541",
        "authorized_official_credential": "RT(R)CT"
    },
    "taxonomies": [
        {
            "code": "2471C1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Cardiovascular-Interventional Technology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471C3401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Radiography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471V0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular-Interventional Technology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.