NPIMap

Organization Active NPI

Griffin Imaging, LLC

  • Radiology Clinic/Center
  • Griffin, GA
National Provider Identifier
1700199940
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
GRIFFIN IMAGING, LLC
Practice address
220 Rock Street
Griffin, GA 30224
Phone
(770) 229-4660
Fax
(770) 229-4632
NPI assigned
Jul 16, 2010
Last updated
Jun 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Authorized official

Name
Mrs. Traci L Brown, MBA
Title
Director of Billing
Phone
(706) 256-3450

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary
Diagnostic Radiology Physician 2085R0202X

Addresses

Primary practice location

220 Rock Street
Griffin, GA 30224

Mailing address

PO Box 931477
Atlanta, GA 31193-1477
Phone (770) 229-4660

Other identifiers 1

IdentifierTypeStateIssuer
DR6432OtherGARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101117000015 GA Part B Supplier - Clinic/Group Practice 9436054129 Receives reassigned benefits from 28 practitioners
1 other NPI on this enrollment
Practice locations: Griffin, GA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2010091Griffin Imaging, LLC220 Rock Street, Griffin, GA 30224Certificate of waiverJul 19, 2028

National Provider Directory

National Provider Directory

Locations

220 Rock St
Griffin, GA 30224
Phone (770) 229-4660

655 Will St
Griffin, GA 30224
Phone (770) 229-6072

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1700199940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931477",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311931477",
            "telephone_number": "770-229-4660",
            "fax_number": "770-229-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ROCK STREET",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "30224",
            "telephone_number": "770-229-4660",
            "fax_number": "770-229-4632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIFFIN IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "706-256-3450",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DR6432",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.