Open MRI of Lagrange LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

OPEN MRI OF LAGRANGE LLC

Practice address

1805 Vernon Rd
Suite D
Lagrange, GA 30240-4041

Phone

(706) 882-1399

Fax

(706) 882-1421

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Robert Randolph Comerford, MD

Title

Medical Director

Phone

(706) 882-1399

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639204142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 VERNON RD",
            "address_2": "SUITE D",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404041",
            "telephone_number": "706-882-1399",
            "fax_number": "706-882-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 VERNON RD",
            "address_2": "SUITE D",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404041",
            "telephone_number": "706-882-1399",
            "fax_number": "706-882-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN MRI OF LAGRANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COMERFORD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "RANDOLPH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "706-882-1399",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00599189B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Physiological Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.