Organization Active NPI

Northwest Diagnostic Imaging, Inc

  • Diagnostic Radiology Physician
  • Conyers, GA
National Provider Identifier
1508847328
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTHWEST DIAGNOSTIC IMAGING, INC
Practice address
2287 Salem Rd SE
Conyers, GA 30013-2025
Phone
(770) 760-0660
Fax
(770) 761-8878
NPI assigned
Nov 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Mr. Daniel J Schaefer
Title
Coo
Phone
(770) 300-0101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X GA Primary

Addresses

Primary practice location

2287 Salem Rd SE
Conyers, GA 30013-2025

Mailing address

PO Box 932391
Atlanta, GA 31193-2391
Phone (678) 393-5600

Other identifiers 4

IdentifierTypeStateIssuer
CH7800OtherGARAILROAD MEDICARE
DA0357OtherGARAILROAD MEDICARE
CA0798OtherGARAILROAD MEDICARE
22687081OtherGAUS DEPARTMENT OF LABOR

Other names 1

  • Open MRI & Imaging of Conyers, LLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1508847328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932391",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932391",
            "telephone_number": "678-393-5600",
            "fax_number": "770-300-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2287 SALEM RD SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132025",
            "telephone_number": "770-760-0660",
            "fax_number": "770-761-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DIAGNOSTIC IMAGING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-300-0101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH7800",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA0357",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA0798",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "22687081",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open MRI & Imaging of Conyers, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.