NPIMap

Organization Active NPI

MDS Digital X-Ray LLC

  • Physiological Laboratory
  • Atlanta, GA
National Provider Identifier
1093032948
Registry record updated Apr 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
MDS DIGITAL X-RAY LLC
Practice address
2250 N Druid Hills Rd NE
Ste 270
Atlanta, GA 30329-3192
Phone
(404) 728-0000
Fax
(404) 728-0801
NPI assigned
Apr 30, 2010
Last updated
Apr 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2010

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

Authorized official

Name
Mr. Fareed A Siddiqui
Title
V. President
Phone
(678) 477-3792

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

2250 N Druid Hills Rd NE
Ste 270
Atlanta, GA 30329-3192

Mailing address

2250 N Druid Hills Rd NE
Ste 270
Atlanta, GA 30329-3192
Phone (404) 728-0000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110221000554 GA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4082745666 Practice locations: Atlanta, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
MDS Digital X-Ray LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2250 N Druid Hills Rd NE
Ste 270
Atlanta, GA 30329
Phone (404) 728-0000

Practitioners & affiliated clinicians

Practitioners 3

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": "1272585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272585600000",
    "number": "1093032948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 N DRUID HILLS RD NE",
            "address_2": "STE 270",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293192",
            "telephone_number": "404-728-0000",
            "fax_number": "404-728-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 N DRUID HILLS RD NE",
            "address_2": "STE 270",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293192",
            "telephone_number": "404-728-0000",
            "fax_number": "404-728-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDS DIGITAL X-RAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-30",
        "last_updated": "2010-04-30",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "FAREED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "V. PRESIDENT",
        "authorized_official_telephone_number": "678-477-3792",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2010; 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.