NPIMap

Organization Active NPI

Women's Imaging Specialists - Eagles Landing, LLC

  • Mammography Clinic/Center
  • Stockbridge, GA
National Provider Identifier
1437502671
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mammography Clinic/CenterTaxonomy code 261QR0206X
Legal business name
WOMEN'S IMAGING SPECIALISTS - EAGLES LANDING, LLC
Practice address
115 Eagle Spring Dr
Suite 100
Stockbridge, GA 30281-6486
Phone
(678) 904-7209
NPI assigned
Jul 22, 2016
Last updated
May 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Jennifer L ReddyNPI 1407303332
Title
Owner
Phone
(404) 428-6107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mammography Clinic/Center 261QR0206X Primary

Addresses

Primary practice location

115 Eagle Spring Dr
Suite 100
Stockbridge, GA 30281-6486

Mailing address

3180 N Point Pkwy Ste 106
Alpharetta, GA 30005-4349
Phone (866) 300-8512

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170525001969 GA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5395012132 Receives reassigned benefits from 1 practitioner
Practice locations: Stockbridge, GA

National Provider Directory

National Provider Directory

Locations

115 Eagle Spring Dr
Ste 100
Stockbridge, GA 30281
Phone (678) 904-7209

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1437502671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 N POINT PKWY STE 106",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054349",
            "telephone_number": "866-300-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 EAGLE SPRING DR",
            "address_2": "SUITE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816486",
            "telephone_number": "678-904-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMEN'S IMAGING SPECIALISTS - EAGLES LANDING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-22",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-428-6107"
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 15, 2023; 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.