Georgia Radiology Services, LLC
Organization Active NPI Diagnostic Radiology Physician · Lagrange, GA
NPI 1124256540 · NPPES record last updated Feb 5, 2020
Key facts
- NPI
- 1124256540
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- GEORGIA RADIOLOGY SERVICES, LLC
- Practice address
- 1514 Vernon Rd
Lagrange, GA 30240-4131 - Phone
- (706) 882-1411
- NPI assigned
- Jun 24, 2009
- Organization subpart
- No
Authorized official
- Name
- Kim H Larsen
- Title
- Director of Credentialing
- Phone
- (770) 874-5400
Practitioners 31
-
William Edwin Behm, M.D.
-
Steven Dustin Bright, M.D.
-
Kevin L Carson, MD
-
Jeremy Ferris, M.D.
-
Jason A Foerter, MD
-
Cameron Caldwell Kersey, M.D.
-
Shane Kudela, MD
-
Courtney Perez, M.D.
-
Michael J Roopas, M.D.
-
Rourke M Stay, MD
-
Naveed Alvi, MD
-
Denis S. Atkinson Jr., M.D.
-
Daniel Johnston Cranford, D.O.
-
Alex Dibona, M.D.
-
Brent Jordan, MD
-
William Todd Lewis, D.O
-
Nausheen Naveed, MBBS
-
Kha C Nguyen, M.D., PH.D.
-
Leland Taylor, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141104001866 | GA | Part B Supplier - Clinic/Group Practice | 6901028174 |
Receives reassigned benefits from 29 practitioners Practice locations: Lagrange, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
1514 Vernon Rd
Lagrange, GA 30240-4131
Mailing address
PO Box 22971
Belfast, ME 04915-4480
Phone (770) 874-5400
Other providers in Lagrange, GA
- Georgia Bone & Joint, LLC
- Georgia CVS Pharmacy LLC
- Georgia CVS Pharmacy LLC
- Georgia CVS Pharmacy, LLC
- Georgia Pain and Spine Care, Inc
- Georgia Specialty Care Staffing Agency
- Georgia Specialty Care Staffing Agency LLC
- Georgia Stars Medical Clinic, LLC
- Amanda German
- Elizabeth Gesselman
All providers in Lagrange, GA · Diagnostic Radiology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.