NPIMap

Individual provider Active NPI

William G Vazquez, MD

  • Diagnostic Radiology Physician
  • Greenwood, SC
National Provider Identifier
1790765063
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
26692 Issued in SC
Practice address
1325 Spring St
Greenwood, SC 29646-3860
Phone
(843) 467-2676
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 055035 GA
Diagnostic Radiology Physician 2085R0202X 26692 SC Primary

Addresses

Primary practice location

1325 Spring St
Greenwood, SC 29646-3860

Mailing address

1303 Azalea CT Ste C
Myrtle Beach, SC 29577-5765
Phone (843) 467-2676

Other identifiers 1

IdentifierTypeStateIssuer
481557006MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041019000009 GA Practitioner - Diagnostic Radiology 4981664414 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University Central del Caribe Escuela de Medicina, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooperative Healthcare Services IncGroup PAC ID 9830093640, 235 clinicians

Practice addresses (Care Compare)

2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone (912) 466-4079

Hospital & facility affiliations

  • Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025
  • Southeast Georgia Health System -- Camden Campus Hospital, Saint Marys, GA, CCN 110146
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
055035GAMDDiagnostic Radiology Physician
26692SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc Diagnostic Radiology CurrentSince Jul 1, 2008 Accepting new patients
Frederica Imaging PC Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Cooperative Healthcare Services Inc Diagnostic Radiology CurrentSince Apr 1, 2025 Accepting new patients
Quantum Medical Radiology PC Diagnostic Radiology PastSince Jan 1, 2007 Accepting new patients
North American Imaging of Buford, LLC Diagnostic Radiology Past Accepting new patients
Georgia Imaging Associates PC Diagnostic Radiology Past Accepting new patients
American Health Imaging of Georgia, LLC Past Accepting new patients
Pin Point Radiology Practice Group, PA Diagnostic Radiology Past Accepting new patients
Community Physicians Open MRI, LLC Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

2000 Dan Proctor Dr
Saint Marys, GA 31558
Phone (912) 576-6160

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790765063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 AZALEA CT STE C",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775765",
            "telephone_number": "843-467-2676",
            "fax_number": "843-497-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463860",
            "telephone_number": "843-467-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "055035",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "26692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "481557006",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.