NPIMap

Organization Active NPI

Tanner Imaging Center

  • Radiology Clinic/Center
  • Carrollton, GA
National Provider Identifier
1154820876
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
TANNER IMAGING CENTER
Practice address
119 Ambulance Dr
Carrollton, GA 30117-3857
Phone
(770) 812-9660
NPI assigned
Feb 8, 2018
Last updated
Feb 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Authorized official

Name
Carol Crews
Title
Cfo
Phone
(770) 812-9580

Specialties & licenses 1

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

Addresses

Primary practice location

119 Ambulance Dr
Carrollton, GA 30117-3857

Mailing address

100 Professional Park Ste. 305
Carrollton, GA 30117
Phone (770) 812-8614

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200219000803 GA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8325475056 Receives reassigned benefits from 49 practitioners
Practice locations: Carrollton, GA

National Provider Directory

National Provider Directory

Locations

119 Ambulance Dr
Carrollton, GA 30117
Phone (770) 812-5605

Practitioners & affiliated clinicians

Practitioners 50

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 50

NPI Registry JSON

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1154820876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL PARK STE. 305",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "30117",
            "telephone_number": "770-812-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-812-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANNER IMAGING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "CREWS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-812-9580"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.