Active NPI
Vidalia Imaging Associates, LLC
- Diagnostic Radiology Physician
- Vidalia, GA
National Provider Identifier
1720102361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- VIDALIA IMAGING ASSOCIATES, LLC
- Practice address
- 1703 Meadows LN
Vidalia, GA 30474-8915 - Phone
- (912) 537-8921
- NPI assigned
- Mar 19, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brenda Sparks
- Title
- Manager
- Phone
- (912) 355-8267
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
1703 Meadows LN
Vidalia, GA 30474-8915
Mailing address
PO Box 13220
Savannah, GA 31416-0220
Phone (912) 355-8188
National Provider Directory
National Provider DirectoryLocations
1703 Meadows Ln
Vidalia, GA 30474
Phone (912) 537-8921
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Edina, MN
- NPI 1801848387
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1184025600000",
"number": "1720102361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13220",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314160220",
"telephone_number": "912-355-8188",
"fax_number": "912-356-6970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1703 MEADOWS LN",
"city": "VIDALIA",
"state": "GA",
"postal_code": "304748915",
"telephone_number": "912-537-8921"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VIDALIA IMAGING ASSOCIATES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-10",
"status": "A",
"authorized_official_last_name": "SPARKS",
"authorized_official_first_name": "BRENDA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "912-355-8267"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vidalia, GA
- Vidalia Family Health Clinic LLC
- Vidalia Health Services, LLC
- Vidalia Health Services, LLC
- Vidalia Health Services, LLC
- Vidalia Health Services, LLC
- Vidalia Immediate & Primary Care LLC
- Vidalia Lab Services, Inc
- Vidalia Medical Associates, PC
- Vidalia Medical Partners Inc.
- Vidalia Neurology Associates, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.