Individual provider Active NPI

Lauren Moomjian, MD

  • Diagnostic Radiology Physician
  • Marietta, GA
National Provider Identifier
1659577716
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME112887 Issued in FL
Practice address
790 Church St NE Ste 400
Marietta, GA 30060-8957
Phone
(770) 405-2976
NPI assigned
Jun 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT190584 PA
Diagnostic Radiology Physician 2085R0202X 0101251828 VA
Diagnostic Radiology Physician 2085R0202X 80618 GA
Diagnostic Radiology Physician 2085R0202X ME112887 FL Primary

Addresses

Primary practice location

790 Church St NE Ste 400
Marietta, GA 30060-8957

Mailing address

PO Box 3157
Indianapolis, IN 46206-3157
Phone (770) 405-2976

Other practice location 1

1250 E Marshall Street
Richmond, VA 23298-0510
Phone (804) 628-3580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190806001459 FL Practitioner - Diagnostic Radiology 2769630052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Jefferson Medical College of Thomas Jefferson University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Radiology PCGroup PAC ID 4385543230, 105 clinicians

Practice addresses (Care Compare)

2510 Miccosukee Rd
Suite 100
Tallahassee, FL 32308-5467
Phone (678) 239-0420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT190584PAMDInternal Medicine Physician
80618GAMDDiagnostic Radiology Physician
0101251828VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Radiology, PC Diagnostic Radiology CurrentSince May 28, 2019 Accepting new patients
American Health Imaging of Georgia, LLC CurrentSince Nov 1, 2021 Accepting new patients
American Health Imaging of Georgia LLC CurrentSince Nov 22, 2019 Accepting new patients
Wellstar Medical Group, LLC Past Accepting new patients
MCV Associated Physicians Diagnostic Radiology PastSince Sep 28, 2021 Accepting new patients

Locations (25 of 59)

2510 Miccosukee Rd
Ste 100
Tallahassee, FL 32308
Phone (850) 942-1100

4550 Cobb Parkway North NW
Ste 109
Acworth, GA 30101
Phone (470) 956-0079

2450 Old Milton Pkwy
Alpharetta, GA 30009
Phone (470) 267-0360

5655 Atlanta Hwy
Alpharetta, GA 30004
Phone (770) 691-0819

12460 Crabapple Rd
Alpharetta, GA 30004
Phone (678) 762-0574

3730 Carmia Dr SW
Ste 110
Atlanta, GA 30331
Phone (404) 344-7286

3890 Redwine Rd SW
Ste 104
Atlanta, GA 30331
Phone (404) 629-4700

1625 Hospital North Dr
Austell, GA 30106
Phone (770) 732-6950

1680 Hospital South Dr
Austell, GA 30106
Phone (678) 945-2100

1025 E West Connector
Ste 520
Austell, GA 30106
Phone (678) 273-3071

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

925 Sanders Rd
Cumming, GA 30041
Phone (404) 567-6500

120 Greystone Power Blvd
Dallas, GA 30157
Phone (470) 267-1540

6001 Professional Pkwy
Douglasville, GA 30134
Phone (404) 274-7335

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

6002 Professional Pkwy
Ste 260
Douglasville, GA 30134
Phone (770) 428-4486

4244 Washington Rd
Evans, GA 30809
Phone (706) 619-1869

307 W Robinson Ave
Grovetown, GA 30813

148 Bill Carruth Pkwy
Ste LL20
Hiram, GA 30141
Phone (770) 443-7700

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (470) 644-7000

144 Bill Carruth Pkwy
Hiram, GA 30141

1120 Wellstar Way
Holly Springs, GA 30114

1550 Kennesaw Due West Rd NW
Kennesaw, GA 30152
Phone (770) 423-9525

3980 Jiles Rd NW
Kennesaw, GA 30144
Phone (678) 504-0100

1180 Ernest W Barrett Pkwy NW
#100
Kennesaw, GA 30144
Phone (770) 644-1274

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1659577716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3157",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063157",
            "telephone_number": "770-405-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CHURCH ST NE STE 400",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608957",
            "telephone_number": "770-405-2976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E MARSHALL STREET",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232980510",
            "country_code": "US",
            "telephone_number": "804-628-3580",
            "fax_number": "804-628-3593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOOMJIAN",
        "first_name": "LAUREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT190584",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101251828",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "80618",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME112887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.