Organization Active NPI

Georgia Magnetic Imaging Center LTD

  • Diagnostic Radiology Physician
  • Macon, GA
National Provider Identifier
1114900545
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
GEORGIA MAGNETIC IMAGING CENTER LTD
Practice address
770 Pine St Ste L15
Attn: Radiology Department
Macon, GA 31201-7519
Phone
(478) 746-1020
Fax
(478) 746-0591
NPI assigned
Nov 21, 2005
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mark E. Grossnickle, MDNPI 1942281076
Title
Partner
Phone
(478) 746-1020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 91

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 91

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AZ, CA, CT, NH, MA, TX, CO, NV, VA, MO, FL, MD, SC, AL, TN, DC, IL, OR, OH, MS, GU, HI, PA, SD, NJ26 enrollments

Enrollment records 26

Enrollment IDStateProvider typePAC IDDetails
O20040420000779 GA Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 37 practitioners
Practice locations: Lake Park, GA; Valdosta, GA; Savannah, GA; Peachtree City, GA; Marietta, GA; Macon, GA; Dunwoody, GA; Cumming, GA…
O20200108001048 AZ Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 3 practitioners
Practice locations: Scottsdale, AZ; Tucson, AZ; Peoria, AZ
O20200108001645 CA Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 4 practitioners
Practice locations: Tarzana, CA; San Francisco, CA; San Diego, CA; Marina del Rey, CA; Rancho Palos Verdes, CA; Irvine, CA
O20200109002313 CT Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: Canton, CT
O20200110000718 NH Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 2 practitioners
Practice locations: Madbury, NH; Raymond, NH
O20200110001092 MA Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: Boston, MA; Arlington, MA
O20200113001940 TX Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 3 practitioners
Practice locations: Dickinson, TX; San Antonio, TX; North Richland Hills, TX
O20200113002295 CO Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 3 practitioners
Practice locations: Colorado Springs, CO; Denver, CO; Fort Collins, CO
O20200114003009 NV Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV
O20200116001217 VA Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 3 practitioners
Practice locations: Ashburn, VA; Gainesville, VA; Virginia Beach, VA
O20200120000173 MO Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO
O20200121001770 FL Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 7 practitioners
Practice locations: St Augustine, FL; Sarasota, FL; Redington Beach, FL; Palm City, FL; Lakewood Ranch, FL; Hollywood, FL; Green Cove Springs, FL; Fort Lauderdale, FL
O20200204000525 MD Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: Berlin, MD
O20200207001568 SC Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 2 practitioners
Practice locations: Greenville, SC; Myrtle Beach, SC
O20200311002058 AL Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: Gadsden, AL; Homewood, AL
O20220207000790 TN Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 3 practitioners
Practice locations: Brentwood, TN; Kingsport, TN; Signal Mountain, TN
O20220310000242 DC Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 2 practitioners
Practice locations: Reston, VA; Vienna, VA
O20220427000955 IL Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: Oak Brook, IL
O20220613000879 OR Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 2 practitioners
Practice locations: Medford, OR; Eugene, OR
O20220927003920 OH Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 2 practitioners
Practice locations: Hudson, OH; Goshen, OH
O20230310001129 MS Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, MS
O20230421001432 GU Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: Chalan Pago, GU
O20230915000655 HI Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 2 practitioners
Practice locations: Kailua, HI; Kapolei, HI
O20231102002105 PA Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: New Kensington, PA
O20231130003634 SD Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: Spearfish, SD
O20240723002995 NJ Part B Supplier - Clinic/Group Practice 0042205775 Receives reassigned benefits from 1 practitioner
Practice locations: Denville, NJ

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

NPPES NPI Registry

Primary practice location

770 Pine St Ste L15
Attn: Radiology Department
Macon, GA 31201-7519

Mailing address

770 Pine St Ste L15
Attn: Radiology Department
Macon, GA 31201-7519
Phone (478) 746-1020

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 6, 2012.

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1114900545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE L15",
            "address_2": "ATTN: RADIOLOGY DEPARTMENT",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017519",
            "telephone_number": "478-746-1020",
            "fax_number": "478-746-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE L15",
            "address_2": "ATTN: RADIOLOGY DEPARTMENT",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017519",
            "telephone_number": "478-746-1020",
            "fax_number": "478-746-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA MAGNETIC IMAGING CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "GROSSNICKLE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "478-746-1020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.