Open MRI of Milledgeville LLC

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

Legal business name

OPEN MRI OF MILLEDGEVILLE LLC

Practice address

1850 North Columbia Street
Suite 3
Milledgeville, GA 31061-7113

Phone

(478) 453-4101

Fax

(706) 256-3454

NPI assigned

Jul 30, 2006

Last updated

Oct 28, 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

Traci Brown

Title

Director of Billing

Phone

(706) 256-3450

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1346255080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933274",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311933274",
            "telephone_number": "866-560-7610",
            "fax_number": "706-256-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 NORTH COLUMBIA STREET",
            "address_2": "SUITE 3",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310617113",
            "telephone_number": "478-453-4101",
            "fax_number": "706-256-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN MRI OF MILLEDGEVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "706-256-3450"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00307290",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.