Shyne Lite Imaging Solutions LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

15033127 Issued in GA

Legal business name

SHYNE LITE IMAGING SOLUTIONS LLC

Practice address

714 Peachtree Station Cir
Peachtree City, GA 30269-2959

Phone

(646) 260-3011

NPI assigned

Jun 16, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Josclyn J Spicer, BS, DMS

Title

Ceo/Owner

Phone

(646) 260-3011

Specialties & licenses 1

Addresses

Other names 1

• Shyne Lite Diagnostic Imaging Other name

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1407237449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 PEACHTREE STATION CIR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302692959",
            "telephone_number": "646-260-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 PEACHTREE STATION CIR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302692959",
            "telephone_number": "646-260-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHYNE LITE IMAGING SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "SPICER",
        "authorized_official_first_name": "JOSCLYN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "646-260-3011",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BS, DMS"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "GA",
            "license": "15033127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shyne Lite Diagnostic Imaging",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Grant N Shuler
• Jennifer Siemer, MS, CCC/SLP
• Gary Steven Siliski, LPC
• Farren Simmons, P.T.A.
• Jennilyn Alexis Simmons, MSN,FNP-C
• Theresa A Simmons, D.D.S.

• Radiology Clinic/Center in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Radiology Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.