Organization Active NPI

Nomadx, Inc.

  • Mobile Radiology Clinic/Center
  • Newnan, GA
National Provider Identifier
1245572403
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
Legal business name
NOMADX, INC.
Practice address
18 Vanderbilt Pointe Way
Newnan, GA 30265-2307
Phone
(404) 826-9279
NPI assigned
Mar 26, 2013
Last updated
Mar 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Authorized official

Name
Mr. Derek J Lucchesi, A.R.R.T
Title
President
Phone
(561) 602-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X NU Primary

Addresses

Primary practice location

18 Vanderbilt Pointe Way
Newnan, GA 30265-2307

Mailing address

18 Vanderbilt Pointe Way
Newnan, GA 30265-2307
Phone (404) 826-9279

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140415001475 GA Part B Supplier - Portable X-Ray Supplier 3173755626 Practice locations: Newnan, GA

National Provider Directory

National Provider Directory

Locations

4 E Washington St
Newnan, GA 30263
Phone (404) 826-9729

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1245572403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 VANDERBILT POINTE WAY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652307",
            "telephone_number": "404-826-9279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 VANDERBILT POINTE WAY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652307",
            "telephone_number": "404-826-9279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOMADX, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "LUCCHESI",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-602-4300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "A.R.R.T"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.