Active NPI
Northwest Diagnostic Imaging, Inc
- Diagnostic Radiology Physician
- Stockbridge, GA
National Provider Identifier
1396726014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA0798 | Other | GA | RAILROAD MEDICARE |
| CH7800 | Other | GA | RAILROAD MEDICARE |
| 226870804 | Other | GA | US DEPARTMENT OF LABOR |
| DA0357 | Other | GA | RAILROAD MEDICARE |
Other names 1
- Open MRI & Imaging of Stockbridge, LLC
National Provider Directory
National Provider DirectoryLocations
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.