NPIMap

Organization Active NPI

Evans Imaging, LLC

  • Radiology Clinic/Center
  • Evans, GA
National Provider Identifier
1144407750
Registry record updated Dec 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
EVANS IMAGING, LLC
Practice address
4350 Towne Center Drive
Suite 1000
Evans, GA 30809
Phone
(706) 868-3940
Fax
(706) 868-3979
NPI assigned
Jan 25, 2008
Last updated
Dec 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2009

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

Authorized official

Name
Dr. Steven G. Rogers, M.D.NPI 1942264981
Title
Medical Director
Phone
(706) 737-4575

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X GA Primary
Mammography Clinic/Center 261QR0206X GA

Addresses

Primary practice location

4350 Towne Center Drive
Suite 1000
Evans, GA 30809

Mailing address

1125 Troupe St
Augusta, GA 30904-4480
Phone (706) 737-4575

Other identifiers 2

IdentifierTypeStateIssuer
000370048UMedicaidGA
GPA958MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080523000002 GA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5597834028 Practice locations: Evans, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2080982Evans Imaging Center4350 Towne Center Drive, Evans, GA 30809Certificate of waiverJul 16, 2028

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260489600000",
    "number": "1144407750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 TROUPE ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044480",
            "telephone_number": "706-737-4575",
            "fax_number": "706-731-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 TOWNE CENTER DRIVE",
            "address_2": "SUITE 1000",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "30809",
            "telephone_number": "706-868-3940",
            "fax_number": "706-868-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2009-12-11",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "706-737-4575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000370048U",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPA958",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.