Snellivlle Medical Imaging

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

2006OCC0013 Issued in GA

Legal business name

SNELLIVLLE MEDICAL IMAGING

Practice address

2310 Henry Clower Blvd
Suite a
Snellville, GA 30078-5776

Phone

(678) 205-2555

Fax

(678) 205-2556

NPI assigned

May 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kendal Cowan

Title

Nuclear Medicine Technologist

Phone

(678) 205-2555

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205886249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 HENRY CLOWER BLVD",
            "address_2": "SUITE A",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785776",
            "telephone_number": "678-205-2555",
            "fax_number": "678-205-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 HENRY CLOWER BLVD",
            "address_2": "SUITE A",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785776",
            "telephone_number": "678-205-2555",
            "fax_number": "678-205-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNELLIVLLE MEDICAL IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COWAN",
        "authorized_official_first_name": "KENDAL",
        "authorized_official_title_or_position": "NUCLEAR MEDICINE TECHNOLOGIST",
        "authorized_official_telephone_number": "678-205-2555"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "GA",
            "license": "2006OCC0013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Maddox Smith, PHARM.D.
• Sade Smith
• Sherlonda Smith
• Yolonda M. Smith, M.D.
• SN Gwinett County Radiation
• Snellville Dental Smiles
• Snellville DME, LLC
• Snellville Medical Group, P.C.
• Snellville Oral Surgery LLC
• Snellville Pediatrics, P.C.

• Multi-Specialty Clinic/Center in Snellville, GA
• Providers in Snellville, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.