Northwest Diagnostic Imaging, Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

NORTHWEST DIAGNOSTIC IMAGING, INC

Practice address

300 Parkbrooke PL
Suite 170
Woodstock, GA 30189-7209

Phone

(678) 494-2345

NPI assigned

Nov 10, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Daniel J Schaefer

Title

Coo

Phone

(770) 300-0101

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Woodstock Diagnostic Imaging, LLC Doing business as

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275004800000",
    "number": "1821079336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932391",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932391",
            "telephone_number": "678-393-5600",
            "fax_number": "770-300-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PARKBROOKE PL",
            "address_2": "SUITE 170",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897209",
            "telephone_number": "678-494-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DIAGNOSTIC IMAGING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2010-05-28",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-300-0101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH7800",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA0357",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "226870800",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA0798",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodstock Diagnostic Imaging, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Woodstock, GA
• Diagnostic Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.