Organization Active NPI

Central Georgia Pet LLC

  • Radiation Oncology Physician
  • Macon, GA
National Provider Identifier
1437149762
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
CENTRAL GEORGIA PET LLC
Practice address
1650 Hardeman Ave
Attn: Radiology Department
Macon, GA 31201-1418
Phone
(478) 633-4738
Fax
(478) 749-9736
NPI assigned
Oct 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Authorized official

Name
Michael Zinsmeister, M.D.NPI 1811987704
Title
Medical Director
Phone
(478) 633-4738

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X Primary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X

Addresses

Primary practice location

1650 Hardeman Ave
Attn: Radiology Department
Macon, GA 31201-1418

Mailing address

1650 Hardeman Ave
Attn: Radiology Department
Macon, GA 31201-1418
Phone (478) 633-4738

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031231000101 GA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6901705706 Practice locations: Macon, GA

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

800 1st St
#170
Macon, GA 31201
Phone (478) 633-4738

800 1st St
Ste 310
Macon, GA 31201
Phone (478) 633-2000

800 1st St
Ste 170
Macon, GA 31201

800 1st St
Ste 110
Macon, GA 31201
Phone (478) 743-3466

Practitioners & affiliated clinicians

Practitioners 8

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": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1437149762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 HARDEMAN AVE",
            "address_2": "ATTN: RADIOLOGY DEPARTMENT",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011418",
            "telephone_number": "478-633-4738",
            "fax_number": "478-749-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 HARDEMAN AVE",
            "address_2": "ATTN: RADIOLOGY DEPARTMENT",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011418",
            "telephone_number": "478-633-4738",
            "fax_number": "478-749-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL GEORGIA PET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "ZINSMEISTER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "478-633-4738",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.