Organization Active NPI

Vidalia Imaging Associates, LLC

  • Diagnostic Radiology Physician
  • Vidalia, GA
National Provider Identifier
1720102361
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
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

Updated by the provider on Jul 10, 2007

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)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

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

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.

Verify at the official NPI Registry.