NPIMap

Organization Active NPI

Imaging Associates of Canton

  • Radiology Clinic/Center
  • Canton, GA
National Provider Identifier
1932155355
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
IMAGING ASSOCIATES OF CANTON
Practice address
200 Oakside LN
Suite a
Canton, GA 30114-6415
Phone
(770) 479-1945
Fax
(770) 479-1948
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Dr. Bradley Robert Peters, M.D.
Title
President / Medical Director
Phone
(770) 479-1945

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

200 Oakside LN
Suite a
Canton, GA 30114-6415

Mailing address

200 Oakside LN
Suite a
Canton, GA 30114-6415
Phone (770) 479-1945

Other identifiers 4

IdentifierTypeStateIssuer
10051310OtherGAAMERIGROUP
129908OtherGAPEACHSTATE
000964268LMedicaidGA
319443OtherGAWELLCARE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1932155355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OAKSIDE LN",
            "address_2": "SUITE A",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301146415",
            "telephone_number": "770-479-1945",
            "fax_number": "770-479-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OAKSIDE LN",
            "address_2": "SUITE A",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301146415",
            "telephone_number": "770-479-1945",
            "fax_number": "770-479-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGING ASSOCIATES OF CANTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT / MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-479-1945",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10051310",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACHSTATE",
            "identifier": "129908",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000964268L",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "319443",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.