Diagnostic Systems of Georgia, LLC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

DIAGNOSTIC SYSTEMS OF GEORGIA, LLC

Doing business as

Coosa Diagnostic Center

Practice address

16 Riverbend Dr
Rome, GA 30161

Phone

(706) 378-0611

Fax

(706) 378-0143

NPI assigned

May 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Richard L Gray

Title

Owner/Ceo

Phone

(706) 354-1036

Specialties & licenses 6

Addresses

Other names 1

• Coosa Diagnostic Center Doing business as

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269993600000",
    "number": "1881644110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1069 BAXTER ST",
            "address_2": "STE C",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-354-1036",
            "fax_number": "706-354-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 RIVERBEND DR",
            "city": "ROME",
            "state": "GA",
            "postal_code": "30161",
            "telephone_number": "706-378-0611",
            "fax_number": "706-378-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC SYSTEMS OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-03-31",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "706-354-1036",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "GA",
            "license": "N/A",
            "primary": false
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "GA",
            "license": "NA",
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "GA",
            "license": "N/A",
            "primary": false
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coosa Diagnostic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Belete Ayele Desimmie
• John J Desmond IV, MD
• Maddison T. Destefano
• Jay E Deville, OWNER
• Diabetic Foot and Ankle Clinic of Georgia, Inc
• Alfonso Diaz Jr., MD
• Chenoa Dickerson, FNP-C
• Mary Difonzo, MARY DIFONZO PA-C
• Mary L Dillard, FNP-BC
• Melissa Stuart Dillmon, MD

• Magnetic Resonance Imaging (MRI) Clinic/Center in Rome, GA
• Providers in Rome, GA by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.