NORTHWEST DIAGNOSTIC IMAGING, INC (NPI# 1609857317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609857317 |
| Entity Type | Organization |
| Organization Name | NORTHWEST DIAGNOSTIC IMAGING, INC |
| Other Organization Name | OPEN MRI & IMAGING OF MACON, LLC |
| Practice Address |
2140 Riverside Dr Macon GA 31204-1747 |
| Mailing Address |
Po Box 932391 Atlanta GA 31193-2391 |
| Practice Telephone | 4787452777 |
| Practice Fax Number | 4787452003 |
| Mailing Telephone | 6783935600 |
| Mailing Fax Number | 7703009018 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2010-09-02 |
| Authorized Official Name | MR. DANIEL J SCHAEFER (COO) |
| Authorized Official Telephone | 7703000101 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RAILROAD MEDICARE | CA0798 | 01 |
| GA | RAILROAD MEDICARE | DA0357 | 01 |
| GA | RAILROAD MEDICARE | CH7801 | 01 |
| Other Name | Type Code |
|---|---|
| Open MRI & Imaging of Macon, LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033150503 | Northwest Diagnostic Imaging, Inc | Radiology | 6630 Mcginnis Ferry Rd, Johns Creek, GA 30097-1542 | 2006-06-08 |
| 1194706606 | Northwest Diagnostic Imaging, Inc | Radiology | 1608 Tree Ln, Building D Suite 400, Snellville, GA 30078-2399 | 2005-11-10 |
| 1457332967 | Northwest Diagnostic Imaging, Inc | Specialist | 2416 Westgate Dr, Albany, GA 31707-8204 | 2005-11-10 |
| 1003897513 | Northwest Diagnostic Imaging, Inc | Radiology | 2706 Watson Blvd, Suite D, Warner Robins, GA 31093-2997 | 2005-11-10 |
| 1821079336 | Northwest Diagnostic Imaging, Inc | Radiology | 300 Parkbrooke Pl, Suite 170, Woodstock, GA 30189-7209 | 2005-11-10 |
| 1225019730 | Northwest Diagnostic Imaging, Inc | Radiology | 100 Mountain View Dr, Suite 200, Cumming, GA 30040-2434 | 2005-11-10 |
| 1023099538 | Northwest Diagnostic Imaging, Inc | Radiology | 600 W Peachtree St Nw, Suit 140, Atlanta, GA 30308-3607 | 2005-11-10 |
| 1851372361 | Northwest Diagnostic Imaging, Inc | Radiology | 638 441 Historic Hwy N, Suite D, Demorest, GA 30535-4566 | 2005-11-10 |
| 1326029828 | Northwest Diagnostic Imaging, Inc | Radiology | 3200 Cobb Galleria Pkwy, Suite 120, Atlanta, GA 30339-5927 | 2005-11-10 |
| 1760463509 | Northwest Diagnostic Imaging, Inc | Radiology | 425 Broad St Se, Gainesville, GA 30501-3712 | 2005-11-09 |
| Street Address |
2140 RIVERSIDE DR |
| City | MACON |
| State | GA |
| Zip Code | 31204-1747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225376866 | Riverside Imaging Specialists, LLC | Clinic/Center | 2140 Riverside Dr, Suite B, Macon, GA 31204-1747 | 2013-01-16 |
| 1609009760 | Open Mri of Georgia, Inc | Radiology | 2140 Riverside Dr, Macon, GA 31204-1747 | 2009-08-24 |
| 1902882657 | Jerry Joseph Smaha | Radiology | 2140 Riverside Dr, Macon, GA 31204 | 2005-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942775085 | Amy Lynn Miller | Counselor | 890 Northwoods Plaza/burrus Road, Macon, GA 31204 | 2018-10-04 |
| 1275056566 | Kenyada Moss | Counselor | 762 Thurmond Dr., Macon, GA 31204 | 2017-07-19 |
| 1508303876 | Amber Foster | Counselor | 890 Northwoods Plaza, Macon, GA 31204 | 2017-01-25 |
| 1952757585 | Sarah Vanselous Spencer | Speech-Language Pathologist | 2720 Sheraton Dr # D-140, Macon, GA 31204 | 2016-05-12 |
| 1952706343 | Matthew Wayne Frazier | Pharmacist | 4260 Log Cabin Dr, Macon, GA 31204 | 2014-10-28 |
| 1215338587 | Sharon Yvette Flewellen | Licensed Practical Nurse | 1876 Moore Street, Macon, GA 31204 | 2014-09-05 |
| 1336565647 | Accel Wellness Center, LLC | Specialist | 3083 Vineville Avenue, Macon, GA 31204 | 2014-03-11 |
| 1821439811 | Irene Gung Ho | Physician Assistant | 3203 Vineville Ave Ste A, Macon, GA 31204 | 2013-07-08 |
| 1518125657 | Jennifer Burns | Marriage & Family Therapist | 116 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| 1255599346 | Methodist Home of The South Georgia Conference, Inc. | Voluntary or Charitable | 304 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| Find all providers in zip 31204 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134101199 | Mark Edward Barrow | Radiology | 770 Pine Street, Suite 290, Macon, GA 31201-7516 | 2005-11-16 |
| 1114908522 | Central Georgia Mri LLC | Radiology | 770 Pine St Ste L15, Attn: Radiology Department, Macon, GA 31201-7519 | 2005-11-11 |
| 1437149762 | Central Georgia Pet LLC | Radiology | 1650 Hardeman Ave, Attn: Radiology Department, Macon, GA 31201-1418 | 2005-10-27 |
| 1326043688 | Arthur Hamilton Mccain | Radiology | 770 Pine St Ste 290, Attn: Radiology Department, Macon, GA 31201-7516 | 2005-06-14 |
| 1235423047 | Burton D Goodwin Jr. | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2011-06-09 |
| 1831495696 | Annie Lee Williams | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2011-01-26 |
| 1982922365 | Joshua Benjamin Cooper | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2010-05-11 |
| 1609009760 | Open Mri of Georgia, Inc | Radiology | 2140 Riverside Dr, Macon, GA 31204-1747 | 2009-08-24 |
| 1194984583 | Alan D Kirsh | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2008-06-02 |
| 1215115233 | James Robert Costello | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2008-01-31 |
| Find all providers in MACON | ||||
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| 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.