NPIMap

Organization Active NPI

Radiology Associates of Valdosta, LLC

  • Diagnostic Radiology Physician
  • Valdosta, GA
National Provider Identifier
1134429582
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY ASSOCIATES OF VALDOSTA, LLC
Practice address
2704 N Oak St
BLDG E
Valdosta, GA 31602-1744
Phone
(229) 249-0353
Fax
(229) 333-0832
NPI assigned
Nov 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Authorized official

Name
Dr. William M Querin, M.D.NPI 1386625499
Title
President
Phone
(229) 333-9729

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

Specialties & licenses 1

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

Addresses

Primary practice location

2704 N Oak St
BLDG E
Valdosta, GA 31602-1744

Mailing address

PO Box 3670
Valdosta, GA 31604-3670
Phone (229) 249-0353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110125000262 GA Part B Supplier - Clinic/Group Practice 5294914198 Receives reassigned benefits from 6 practitioners
Practice locations: Valdosta, GA

National Provider Directory

National Provider Directory

Locations

2704 N Oak St
Bldg E
Valdosta, GA 31602
Phone (229) 249-0353

Practitioners & affiliated clinicians

Practitioners 8

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": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1134429582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3670",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316043670",
            "telephone_number": "229-249-0353",
            "fax_number": "229-333-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 N OAK ST",
            "address_2": "BLDG E",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021744",
            "telephone_number": "229-249-0353",
            "fax_number": "229-333-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF VALDOSTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "QUERIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-333-9729",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "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 Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.