Northside Imaging LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

NORTHSIDE IMAGING LLC

Practice address

638 441 Historic Hwy N
Suite D
Demorest, GA 30535-4574

Phone

(706) 454-9900

NPI assigned

May 24, 2016

Last updated

May 24, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jorge J Hernandez

Title

VP-Admin, Cco

Phone

(404) 851-6378

Specialties & licenses 1

Addresses

Tax ID family

Northside Imaging LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Northside Imaging LLC

  • Diagnostic Radiology Physician
  • Warner Robins, GA
  • NPI 1316394976
  NPD tax ID
• Northside Imaging LLC

  • Diagnostic Radiology Physician
  • Athens, GA
  • NPI 1669829214
  NPD tax ID

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1699122291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 441 HISTORIC HWY N",
            "address_2": "SUITE D",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "305354574",
            "telephone_number": "706-454-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP-ADMIN, CCO",
        "authorized_official_telephone_number": "404-851-6378"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Georgia Home Health III LLC
• Northeast Georgia Medical Center Habersham LLC
• Northeast Georgia Medical Center Habersham LLC
• Northeast Georgia Medical Center Habersham LLC
• Northeast Georgia Medical Habersham LLC
• Northwest Diagnostic Imaging, Inc (MRI & Imaging of Habersham, LLC)
• Ogles Oxygen, LLC
• Richard A Olson, MD
• Open MRI of Georgia, Inc (Open MRI & Imaging of Habersham)
• Thomas A Opilka, CRNA

• Diagnostic Radiology Physician in Demorest, GA
• Providers in Demorest, GA by specialty
• Diagnostic Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.