Active NPI
Atlanta VA Medical Center
- Computed Tomography Radiologic Technologist
- Detroit, MI
National Provider Identifier
1063288702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Computed Tomography Radiologic Technologist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular-Interventional Technology Radiologic Technologist | 2471C1101X | |||
| Computed Tomography Radiologic Technologist | 2471C3401X | Primary | ||
| Radiography Radiologic Technologist | 2471C3402X | |||
| Vascular-Interventional Technology Radiologic Technologist | 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 DirectoryNPI 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.