Central Georgia MRI LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

CENTRAL GEORGIA MRI LLC

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 11, 2005

Last updated

Nov 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark E. Grossnickle, M.D.NPI 1942281076

Title

President

Phone

(478) 746-1020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

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

Enrollment records 26

Member of 1

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

• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Cabarrus Inpatient Psych Unit

  • Psychiatric Hospital Unit
  • Concord, NC
  • NPI 1629283866

  Member Of

  NPD member

Locations

Practitioners 78

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.

• Mark E Grossnickle, MD

  • Diagnostic Radiology Physician
  • Macon, GA
  • NPI 1942281076
  Medicare reassignment Care Compare group NPD Authorized official
• Fayyaz Barodawala, M.D.

  • Vascular & Interventional Radiology Physician
  • Macon, GA
  • NPI 1942238084

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Mark Edward Barrow, MD

  • Diagnostic Radiology Physician
  • Macon, GA
  • NPI 1134101199
  Medicare reassignment Care Compare group NPD
• Ericha Ross Benshoff, MD

  • Diagnostic Radiology Physician
  • Macon, GA
  • NPI 1770573503
  Medicare reassignment Care Compare group NPD
• Kathleen M Carrigan, MD

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1306072616
  Medicare reassignment Care Compare group NPD
• Carol Lynn Collings, MD

  • Diagnostic Radiology Physician
  • Macon, GA
  • NPI 1275523086
  Medicare reassignment Care Compare group NPD
• Joshua Benjamin Cooper, MD

  • Diagnostic Radiology Physician
  • Macon, GA
  • NPI 1982922365
  Medicare reassignment Care Compare group NPD
• Karekin R Cunningham, MD

  • Diagnostic Radiology Physician
  • Macon, GA
  • NPI 1316162779
  Medicare reassignment Care Compare group NPD
• Marcus Christopher Evans, MD

  • Diagnostic Radiology Physician
  • Macon, GA
  • NPI 1831310861
  Medicare reassignment Care Compare group NPD
• Hugo Falcon Jr., MD

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1912989971
  Medicare reassignment Care Compare group NPD
• Michael T Jones, MD

  • Diagnostic Radiology Physician
  • Macon, GA
  • NPI 1962492736
  Medicare reassignment Care Compare group NPD
• Mark William Keenan, MD

  • Diagnostic Radiology Physician
  • Macon, GA
  • NPI 1932199742
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1114908522",
    "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": "CENTRAL GEORGIA MRI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "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": "PRESIDENT",
        "authorized_official_telephone_number": "478-746-1020",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Macon, GA
• Providers in Macon, GA by specialty
• Diagnostic Radiology Physician in Georgia

• 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.