Pet Imaging Center of Gwinnett LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

PET IMAGING CENTER OF GWINNETT LLC

Practice address

555 Old Norcross Rd
115
Lawrenceville, GA 30046-8716

Phone

(770) 277-0501

Fax

(770) 277-4324

NPI assigned

Sep 21, 2010

Organization subpart

Yes

Parent organization

TRIDENT MEDICAL IMAGINGAs reported in NPPES

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

Authorized official

Name

Crystal Gates

Title

Director of Patient Accounts

Phone

(770) 692-1387

Specialties & licenses 1

Addresses

Other names 1

• Trident Medical Imaging- Gwinnett Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott Charles Bartley, MD

  • Nuclear Medicine Physician
  • Saint Cloud, MN
  • NPI 1770505919
  NPD (past)

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1750699005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 54 W",
            "address_2": "103",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144549",
            "telephone_number": "770-692-1387",
            "fax_number": "770-692-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 OLD NORCROSS RD",
            "address_2": "115",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468716",
            "telephone_number": "770-277-0501",
            "fax_number": "770-277-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PET IMAGING CENTER OF GWINNETT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRIDENT MEDICAL IMAGING",
        "enumeration_date": "2010-09-21",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "770-692-1387"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trident Medical Imaging- Gwinnett",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sonia Patricia Perpignan
• Cheryl Anne Perry, ACBSW
• Ja'Nay Amour Perry
• Tracy Perry, APRN, FNP-C
• Amber Person
• Dawn Marie Peters, NCMT
• Jessica Rogers Peters
• Joslyn Peters
• Micayla Anne Peters
• Nicole Elizabeth Peters, PA-C

• 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 Sep 21, 2010; 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.