Active NPI
Amanda Lauren Maldonado, RT
- Radiography Radiologic Technologist
- Savannah, GA
National Provider Identifier
1063711380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiography Radiologic Technologist
- License
- 435024
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 435024 | GA | MD | Radiography 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.