NPIMap

Organization Active NPI

Quantum Medical Radiology PC

  • Diagnostic Radiology Physician
  • Smyrna, GA
National Provider Identifier
1164475869
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
QUANTUM MEDICAL RADIOLOGY PC
Practice address
3949 S Cobb Dr SE
Smyrna, GA 30080-6342
Phone
(770) 434-0710
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Authorized official

Name
Robert R Roche, M.D.NPI 1932189842
Title
Authorized Representative
Phone
(678) 904-2590

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

3949 S Cobb Dr SE
Smyrna, GA 30080-6342

Mailing address

PO Box 1168780
Atlanta, GA 30368-6878
Phone (678) 904-2599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, VA, TN, HI4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20031211000366 GA Part B Supplier - Clinic/Group Practice 3577468040 Receives reassigned benefits from 28 practitioners
Practice locations: Dawsonville, GA; Johnson City, TN; Greensboro, GA; Forysthe, GA; Covington, GA; Colquitt, GA; Atlanta, GA
O20150310000375 VA Part B Supplier - Clinic/Group Practice 3577468040 Receives reassigned benefits from 1 practitioner
Practice locations: Centreville, VA; Glen Allen, VA; Leesburg, VA; Middleburg, VA
O20151106001377 TN Part B Supplier - Clinic/Group Practice 3577468040 Receives reassigned benefits from 1 practitioner
Practice locations: Soddy Daisy, TN
O20161229000348 HI Part B Supplier - Clinic/Group Practice 3577468040 Receives reassigned benefits from 1 practitioner
Practice locations: Captain Cook, HI

National Provider Directory

National Provider Directory
Tax ID family
North Florida Neurosurgery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1101 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 486-2154

6222 Wilshire Blvd
Los Angeles, CA 90048
Phone (770) 779-2171

8929 University Center Ln
Ste 370
San Diego, CA 92122
Phone (858) 756-2040

6510 NW 9th Blvd
Ste 1
Gainesville, FL 32605
Phone (352) 331-0811

555 Peachtree St NE
Atlanta, GA 30308
Phone (404) 255-5767

3790 Pleasant Hill Rd
Ste 140
Duluth, GA 30096
Phone (404) 623-5551

600 S 8th St
Griffin, GA 30224
Phone (678) 603-1381

3969 S Cobb Dr SE
Ste 101
Smyrna, GA 30080
Phone (404) 446-0085

59 Damonte Ranch Pkwy
Ste B104
Reno, NV 89521
Phone (916) 572-7846

PO Nox 72036
Cleveland, OH 44192

Practitioners & affiliated clinicians

Practitioners 135

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 135

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1164475869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1168780",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303686878",
            "telephone_number": "678-904-2599",
            "fax_number": "678-904-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806342",
            "telephone_number": "770-434-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUANTUM MEDICAL RADIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "ROCHE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "678-904-2590",
        "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 Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.