ADVANCED SOUTHERN IMAGING (NPI# 1184242398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184242398 |
| Entity Type | Organization |
| Organization Name | ADVANCED SOUTHERN IMAGING |
| Practice Address |
1390 Business Center Dr Sw Ste 700 Conyers GA 30094-6600 |
| Practice Telephone | 8443372837 |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-14 |
| Authorized Official Name | HOLLY HUGHES (MANAGER) |
| Authorized Official Telephone | 7063670830 |
| Authorized Official Credential | RDMS, RVT, RDCS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0207X |
Clinic/Center Specialization: Radiology, Mobile Mammography |
Ambulatory Health Care Facilities |
| Street Address |
1390 BUSINESS CENTER DR SW STE 700 |
| City | CONYERS |
| State | GA |
| Zip Code | 30094-6600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1659838571 | Sensitive Home Care Agency Inc. | PACE Provider Organization | 2225 Morning Dew, Conyers, GA 30094 | 2019-02-27 |
| 1679097992 | Sheira Dennis | Case Management | 3828 Martingale Dr Se, Conyers, GA 30094 | 2017-07-28 |
| 1730571399 | Wellness and Trauma Recovery Center | Counselor | 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 | 2015-02-19 |
| 1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
| 1538567466 | Jennifer Angela Johnson | Registered Nurse | 2240 Wren Rd Se, Conyers, GA 30094 | 2014-12-09 |
| 1225445208 | Wanda Marcella Rainey-reed | Counselor | 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 | 2014-07-22 |
| 1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
| 1720219660 | Candace Alexander | Dentist | 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 | 2009-07-27 |
| Find all providers in zip 30094 | ||||
| Taxonomy Code | 261QR0207X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile Mammography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700492238 | Cherokee Rose Mammography LLC | Clinic/Center | 121 Forte Ave Nw, Milledgeville, GA 31061-8062 | 2020-09-21 |
| 1487000493 | Digital Mammography Specialists - Mobile, LLC. | Clinic/Center | 12460 Crabapple Rd, Suite 202-151, Alpharetta, GA 30004-6602 | 2016-05-09 |
Please comment or provide details below to improve the information on ADVANCED SOUTHERN IMAGING.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.