Physician Diagnostic Services LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

PHYSICIAN DIAGNOSTIC SERVICES LLC

Doing business as

PDSHeart

Practice address

2425 Wall St SE
Conyers, GA 30013-6342

Phone

(678) 487-1266

Fax

(240) 371-8541

NPI assigned

Jul 15, 2005

Last updated

Apr 29, 2008By 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

Angela Marie Nauful

Title

Vice President, Accounts Receivable

Phone

(678) 487-1266

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• PDSHeart Doing business as

Locations

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1871592501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 WALL ST SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136342",
            "telephone_number": "678-487-1266",
            "fax_number": "240-371-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 WALL ST SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136342",
            "telephone_number": "678-487-1266",
            "fax_number": "240-371-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN DIAGNOSTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "NAUFUL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "VICE PRESIDENT, ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "678-487-1266"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019144200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PDSHeart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phenomenal Care Solutions
• Hailei Phillips, LAPC
• Marcia Angella Phillips, PMHNP-BC
• Tonika Phillips
• Nicholas Phung, D.M.D
• Physiotherapy Associates Inc (Physio-Conyers)
• Piedmont Rockdale Hospital Inc.
• Myrienne Pierre
• Julia Pike
• Laura Renee Pinkney, NP-C

• Physiological Laboratory in Conyers, GA
• Providers in Conyers, GA by specialty
• Physiological Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.