Individual provider Active NPI

Amira Karriem, MBA, BS, RT

  • Radiography Radiologic Technologist
  • Dallas, GA
National Provider Identifier
1700432267
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
326204 Issued in GA
Practice address
256 Valley View Cir
Dallas, GA 30132-9806
Phone
(678) 903-5786
Fax
(888) 545-1070
NPI assigned
Aug 12, 2019
Last updated
Jun 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic Technologist 2471C3402X 326204 GA Primary

Addresses

Primary practice location

256 Valley View Cir
Dallas, GA 30132-9806

Mailing address

256 Valley View Cir Lot 59
Dallas, GA 30132-9806
Phone (404) 861-4087

Other identifiers 1

IdentifierTypeStateIssuer
003234554AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science, Master of Business Administration

State licenses

LicenseStateTypeSpecialty
326204GAMDRadiography Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Pink Ribbon Mammography and Diagnostic Radiology Services LLC CurrentSince Aug 1, 2019 Accepting new patients

Organizations & group practices 1

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": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1700432267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 VALLEY VIEW CIR LOT 59",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301329806",
            "telephone_number": "404-861-4087",
            "fax_number": "888-545-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 VALLEY VIEW CIR",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301329806",
            "telephone_number": "678-903-5786",
            "fax_number": "888-545-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARRIEM",
        "first_name": "AMIRA",
        "name_prefix": "Mrs.",
        "credential": "MBA, BS, RT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "GA",
            "license": "326204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003234554A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.