Bca Georgia, LLC
Organization Active NPI Radiology Clinic/Center · Milledgeville, GA
NPI 1679294227 · NPPES record last updated Feb 10, 2023
Key facts
- NPI
- 1679294227
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Radiology Clinic/Center 261QR0200X
- Legal business name
- BCA GEORGIA, LLC
- Practice address
- 1850 N Columbia St Ste 3
Milledgeville, GA 31061-7113 - Phone
- (478) 453-4101
- NPI assigned
- Sep 12, 2022
- Organization subpart
- No
Authorized official
- Name
- Dr. Gary Harper Dent, MD
- Title
- Ceo
- Phone
- (912) 764-2455
Member organizations 1
Practitioners 42
-
Charles Miller Brown Sr., M.D.
-
Charles W Brown, M.D.
-
Brent S Deem, DO
-
Gary H Dent, MD
-
Anna S Franklin, M.D.
-
Jeremy Hill, MD
-
Michael Paul Holcombe, M.D.
-
Michael K Kizziah, M.D.
-
Kevin D Phillips, MD
-
Matthew Patrick Reaves, PA-C
-
Laurence Steinfeld, M.D.
-
William A Willoughby, M.D.
-
Robert S Andrews, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2038013 | Lakeside Imaging | Certificate of waiver | Mar 11, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230320001720 | GA | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 3072987742 | Practice locations: Milledgeville, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | Yes |
Addresses
Primary practice location
1850 N Columbia St Ste 3
Milledgeville, GA 31061-7113
Mailing address
PO Box 1067
Statesboro, GA 30459-1067
Phone (912) 764-2455
Other names
- Lakeside Imaging
Other providers in Milledgeville, GA
- Barbz Angels LLC
- Jomandi Laris Barnes
- Trenton Chandler Bateman
- Madison Bauer
- Nolan Baugh
- Bcas, Inc.
- Robin Beavers
- Claudia Hope Bell
- Wendy Arlene Bell
- Kayla Bennett
All providers in Milledgeville, GA · Radiology Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.