Providence Imaging, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

PROVIDENCE IMAGING, LLC

Practice address

1760 Bass Rd Ste 102
Macon, GA 31210-1098

Phone

(478) 259-6051

Fax

(478) 259-2124

NPI assigned

Jan 18, 2022

Last updated

Jul 30, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tonya Stokes

Title

Ceo

Phone

(850) 562-1656

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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.

• Kevin L Carson, MD

  • Vascular & Interventional Radiology Physician
  • Atlanta, GA
  • NPI 1649257825
  NPD

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753833600000",
    "number": "1447901889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5016 NELLY LN",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323038284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 BASS RD STE 102",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101098",
            "telephone_number": "478-259-6051",
            "fax_number": "478-259-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-562-1656"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Van Ness Pritchett, FNP
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• Radiology Clinic/Center in Macon, GA
• Providers in Macon, 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 Jul 30, 2025; 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.