Individual provider Active NPI

Amanda Lauren Maldonado, RT

  • Radiography Radiologic Technologist
  • Savannah, GA
National Provider Identifier
1063711380
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
435024 Issued in GA
Practice address
230 Duncan Dr BLDG 1440
Department of Radiology
Savannah, GA 31409-5107
Phone
(912) 315-6464
Fax
(913) 315-5397
NPI assigned
Mar 25, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Computed Tomography Radiologic Technologist 2471C3401X 435024
Radiography Radiologic Technologist 2471C3402X 435024 GA Primary

Addresses

Primary practice location

230 Duncan Dr BLDG 1440
Department of Radiology
Savannah, GA 31409-5107

Mailing address

105 Summer Hill Way
Richmond Hill, GA 31324-4530
Phone (912) 342-3663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
435024GAMDRadiography Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1063711380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SUMMER HILL WAY",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313244530",
            "telephone_number": "912-342-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 DUNCAN DR BLDG 1440",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314095107",
            "telephone_number": "912-315-6464",
            "fax_number": "913-315-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "AMANDA",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "RT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-25",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3401X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": null,
            "license": "435024",
            "primary": false
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "GA",
            "license": "435024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; 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.