Medica Stand-Up MRI, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

621512 Issued in GA

Legal business name

MEDICA STAND-UP MRI, LLC

Doing business as

Medica Stand-Up MRI of Atlanta

Practice address

6590 Powers Ferry Rd NW
Atlanta, GA 30339-2933

Phone

(770) 953-0108

Fax

(770) 953-0109

NPI assigned

Jun 3, 2006

Last updated

Aug 22, 2020By 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

Mary Kay Baker

Title

VP of Operations

Phone

(678) 354-6766

Specialties & licenses 1

Addresses

Other names 1

• Medica Stand-Up MRI of Atlanta Doing business as

Practitioners 1

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.

• Kenneth J Lazarus, MD,PHD

  • Neurology Physician
  • Fayetteville, GA
  • NPI 1689602385
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801834551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6590 POWERS FERRY RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392933",
            "telephone_number": "770-953-0108",
            "fax_number": "770-953-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6590 POWERS FERRY RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392933",
            "telephone_number": "770-953-0108",
            "fax_number": "770-953-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICA STAND-UP MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "678-354-6766"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "GA",
            "license": "621512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medica Stand-Up MRI of Atlanta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Radiology Clinic/Center in Atlanta, GA
• Providers in Atlanta, 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 Aug 22, 2020; 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.