Organization Active NPI

Women'S Imaging Specialists - Monroe, LLC

  • Mammography Clinic/Center
  • Monroe, GA
National Provider Identifier
1972128460
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mammography Clinic/CenterTaxonomy code 261QR0206X
Legal business name
WOMEN'S IMAGING SPECIALISTS - MONROE, LLC
Practice address
500 Great Oaks Dr Ste 13
Monroe, GA 30655-8228
Phone
(866) 300-8512
NPI assigned
Jun 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Jennifer L Reddy
Title
Owner
Phone
(404) 692-3493

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mammography Clinic/Center 261QR0206X Primary

Addresses

Primary practice location

500 Great Oaks Dr Ste 13
Monroe, GA 30655-8228

Mailing address

3180 N Point Pkwy Ste 106
Alpharetta, GA 30005-4349
Phone (866) 300-8512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201001000363 GA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0941629547 Practice locations: Monroe, GA

National Provider Directory

National Provider Directory

Locations

500 Great Oaks Dr
Ste 13
Monroe, GA 30655
Phone (706) 785-0500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1972128460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 N POINT PKWY STE 106",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054349",
            "telephone_number": "866-300-8512",
            "fax_number": "800-613-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GREAT OAKS DR STE 13",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306558228",
            "telephone_number": "866-300-8512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMEN'S IMAGING SPECIALISTS - MONROE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-10",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-692-3493"
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.