NPIMap

Organization Active NPI

Prodocs LLC

  • Diagnostic Radiology Physician
  • Saint Marys, GA
National Provider Identifier
1346580586
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PRODOCS LLC
Practice address
2000 Dan Proctor Dr
Saint Marys, GA 31558-3810
Phone
(800) 841-4236
NPI assigned
Feb 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Authorized official

Name
Joshua Blaclmon
Title
MD
Phone
(800) 841-4236

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

2000 Dan Proctor Dr
Saint Marys, GA 31558-3810

Mailing address

2000 Dan Proctor Dr
Saint Marys, GA 31558-3810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130314000194 GA Part B Supplier - Clinic/Group Practice 1355586678 Receives reassigned benefits from 2 practitioners
Practice locations: Madison, GA

National Provider Directory

National Provider Directory

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1346580586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 DAN PROCTOR DR",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 DAN PROCTOR DR",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583810",
            "telephone_number": "800-841-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODOCS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "BLACLMON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "800-841-4236"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.