Organization Active NPI

Northwest Diagnostic Imaging, Inc

  • Diagnostic Radiology Physician
  • Stockbridge, GA
National Provider Identifier
1396726014
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTHWEST DIAGNOSTIC IMAGING, INC
Practice address
204 Village Center Pkwy
Stockbridge, GA 30281-9044
Phone
(678) 565-6364
Fax
(678) 565-9909
NPI assigned
Nov 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Mr. Daniel J Schaefer
Title
Coo
Phone
(770) 300-0101

Specialties & licenses 1

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

Addresses

Primary practice location

204 Village Center Pkwy
Stockbridge, GA 30281-9044

Mailing address

PO Box 932391
Atlanta, GA 31193-2391
Phone (678) 393-5600

Other identifiers 4

IdentifierTypeStateIssuer
CA0798OtherGARAILROAD MEDICARE
CH7800OtherGARAILROAD MEDICARE
226870804OtherGAUS DEPARTMENT OF LABOR
DA0357OtherGARAILROAD MEDICARE

Other names 1

  • Open MRI & Imaging of Stockbridge, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

204 Village Center Pkwy
Stockbridge, GA 30281
Phone (678) 565-6364

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1396726014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932391",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932391",
            "telephone_number": "678-393-5600",
            "fax_number": "770-300-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 VILLAGE CENTER PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819044",
            "telephone_number": "678-565-6364",
            "fax_number": "678-565-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DIAGNOSTIC IMAGING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-300-0101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA0798",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH7800",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "226870804",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA0357",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open MRI & Imaging of Stockbridge, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.