Georgia Health Imaging

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

GEORGIA HEALTH IMAGING

Practice address

3653 Lawrenceville Hwy
Suite 150
Lawrenceville, GA 30044-4107

Phone

(678) 924-0964

Fax

(678) 924-0965

NPI assigned

Feb 26, 2007

Last updated

Feb 18, 2009By 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

Yasmin Budhwani, MBBS, RDMS

Title

Administrator

Phone

(678) 924-0964

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Progressive Health LLC Other name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 5

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.

• Jack Nathaniel Newman Jr., M.D.

  • Cardiovascular Disease Physician
  • Phoenix, MD
  • NPI 1215915012

  GA

  Medicare reassignment NPD
• Elliott Jay Wagner, M.D.

  • Diagnostic Radiology Physician
  • Beverly Hills, CA
  • NPI 1558312579

  GA

  Medicare reassignment NPD
• Lloyd David Wagner, M.D.

  • Diagnostic Radiology Physician
  • Camden, NJ
  • NPI 1124161872

  GA

  Medicare reassignment NPD
• Khalid Jalil Hayat, M.D.

  • Cardiovascular Disease Physician
  • Lawrenceville, GA
  • NPI 1578563953
  NPD (past)
• Douglas C. Redd, M.D.

  • Specialist
  • Atlanta, GA
  • NPI 1205824497
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1700912532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3653 LAWRENCEVILLE HWY",
            "address_2": "STE 150",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444107",
            "telephone_number": "678-924-0964",
            "fax_number": "678-924-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3653 LAWRENCEVILLE HWY",
            "address_2": "SUITE 150",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444107",
            "telephone_number": "678-924-0964",
            "fax_number": "678-924-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA HEALTH IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "BUDHWANI",
        "authorized_official_first_name": "YASMIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "678-924-0964",
        "authorized_official_credential": "MBBS, RDMS"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000502796N",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN #",
            "identifier": "GRP8122",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Progressive Health LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Georgia CVS Pharmacy, L.L.C. (CVS Pharmacy #02570)
• Georgia Diagnostic Centers
• Georgia Eye Associates, P.C.
• Georgia Eye Group LLC
• Georgia Family Resources LLC
• Georgia Health Imaging
• Georgia Health Imaging, LLC
• Georgia Healthcare Alternatives Inc.
• Georgia Injury Center of Lawrenceville LLC
• Georgia Interventional Pain LLC

• Radiology Clinic/Center in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Radiology Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.