NPIMap

Organization Active NPI

Medlink Georgia, Inc

  • Radiology Clinic/Center
  • Commerce, GA
National Provider Identifier
1487337176
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MEDLINK GEORGIA, INC
Practice address
112 Banks Rd.
Ste. 2
Commerce, GA 30529-6300
Phone
(706) 788-3234
NPI assigned
Aug 9, 2023
Organization subpart
Yes
Parent organization
MEDLINK GEORGIA, INCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Dave Ward
Title
Ceo
Phone
(706) 788-3234

Corporate family (same tax ID) 45

Organizations that report the same tax identification number in the National Provider Directory.

View all 45

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medlink Habersham
Demorest, GA · CCN 111975		 Federally qualified health center Operational/Managerial Control Jan 13, 2014
Medlink Monroe
Monroe, GA · CCN 111037		 Federally qualified health center Operational/Managerial Control (100%) Jun 5, 2023
Medlink Danielsville
Danielsville, GA · CCN 111049		 Federally qualified health center Operational/Managerial Control (100%) Jan 14, 2022
Medlink Winder Womens Center
Winder, GA · CCN 111050		 Federally qualified health center Operational/Managerial Control (100%) Nov 1, 2016
Medlink Commerce
Commerce, GA · CCN 111084		 Federally qualified health center Operational/Managerial Control (100%) Feb 8, 2018
Medlink Jefferson
Jefferson, GA · CCN 111141		 Federally qualified health center Operational/Managerial Control (100%) Mar 1, 2021
Medlink Suches
Suches, GA · CCN 851107		 Federally qualified health center Operational/Managerial Control (100%) Oct 20, 2021
Medlink Cleveland
Cleveland, GA · CCN 851100		 Federally qualified health center Operational/Managerial Control (100%) Oct 1, 2021
Medlink Georgia Inc
Cleveland, GA · CCN 111898		 Federally qualified health center Operational/Managerial Control (100%) Oct 1, 2022
Medlink Oconee
Watkinsville, GA · CCN 851834		 Federally qualified health center Operational/Managerial Control (100%) Apr 22, 2023
Medlink Athens
Athens, GA · CCN 851950		 Federally qualified health center Operational/Managerial Control (100%) Aug 3, 2023

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240104000893 GA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3274442850 Practice locations: Commerce, GA

National Provider Directory

Tax ID family
Oglethorpe Family Medic (46 organizations share this tax ID)
Part of
Oglethorpe Family Medic

Locations

112 Banks Rd
Ste 2
Commerce, GA 30529
Phone (706) 521-4967

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

NPPES NPI Registry

Primary practice location

112 Banks Rd.
Ste. 2
Commerce, GA 30529-6300

Mailing address

PO Box 459
Colbert, GA 30628-0459
Phone (706) 788-3234

Other names 1

NPPES NPI Registry
  • MedLink Banks Imaging Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 20, 2023.

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1487337176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "COLBERT",
            "state": "GA",
            "postal_code": "306280459",
            "telephone_number": "706-788-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BANKS RD.",
            "address_2": "STE. 2",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305296300",
            "telephone_number": "706-788-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLINK GEORGIA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDLINK GEORGIA, INC",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-15",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-788-3234"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedLink Banks Imaging",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MedLink Banks Imaging",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Commerce, GA

Sources for this page

Verify at the official NPI Registry.