NORTHSIDE IMAGING LLC (NPI# 1699122291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699122291 |
| Entity Type | Organization |
| Organization Name | NORTHSIDE IMAGING LLC |
| Practice Address |
638 441 Historic Hwy N Suite D Demorest GA 30535-4574 |
| Mailing Address |
1000 Johnson Fy Rd Ne Atlanta GA 30342-1606 |
| Practice Telephone | 7064549900 |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |
| Authorized Official Name | JORGE J HERNANDEZ (VP-ADMIN, CCO) |
| Authorized Official Telephone | 4048516378 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669829214 | Northside Imaging LLC | Radiology | 845 Prince Ave, Athens, GA 30606-2723 | 2016-05-24 |
| 1316394976 | Northside Imaging LLC | Radiology | 2706 Watson Blvd, Suite D, Warner Robins, GA 31093-2997 | 2016-05-24 |
| 1740351477 | Northside Imaging LLC | Radiology | 6006 49th Street North, Suite 140, St Petersburg, FL 33709 | 2006-11-13 |
| 1063402279 | Northside Imaging LLC | Radiology | 6006 49th St N, Ste 140, St Petersburg, FL 33709-2148 | 2005-10-27 |
| Street Address |
638 441 HISTORIC HWY N SUITE D |
| City | DEMOREST |
| State | GA |
| Zip Code | 30535-4574 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851372361 | Northwest Diagnostic Imaging, Inc | Radiology | 638 441 Historic Hwy N, Suite D, Demorest, GA 30535-4566 | 2005-11-10 |
| 1407235815 | Mri & Imaging of Georgia, LLC | Clinic/Center | 638 441 Historic Hwy N, Suite D, Demorest, GA 30535-4574 | 2015-05-19 |
| 1942432646 | Open Mri of Georgia, Inc | Radiology | 638 441 Historic Hwy N, Suite D, Demorest, GA 30535-4566 | 2009-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396353355 | Kristen Diana Maxwell X | Nurse Practitioner | 396 Historic Highway 441 North, Demorest, GA 30535 | 2020-07-16 |
| 1659925972 | Jared Davis | Physical Therapist | 541 Historic Hiwy 441, Demorest, GA 30535 | 2019-07-25 |
| 1669939070 | Habersham Medical Center Foundation, Inc. | Pharmacy | 541 Old Historic Hwy 441 N Ste 1, Demorest, GA 30535 | 2019-02-22 |
| 1114417128 | The Hospital Authority of Habersham County | Family Medicine | 638 Hwy 441 N Suite B-2, Demorest, GA 30535 | 2018-05-15 |
| 1578077434 | Linh My Dao | Registered Nurse | 541 Historic Hwy. 441-n, Demorest, GA 30535 | 2017-11-29 |
| 1447797063 | Cmvo, LLC | Pharmacy | 4654 Highway 115, Unit 1, Demorest, GA 30535 | 2017-01-20 |
| 1851741128 | Katherine Glenn | Physical Therapy Assistant | 541 Us-441 Bus, Demorest, GA 30535 | 2016-06-17 |
| 1558735886 | Waterfall Emergency Physicians, LLC | Physician Assistant | 541 Historic Hwy 441n, Demorest, GA 30535 | 2015-11-24 |
| 1407278237 | Deborah Gale | Pharmacist | 116 Savannah Ter, Demorest, GA 30535 | 2014-01-14 |
| 1538580576 | Garrett Family Medicine, LLC | Family Medicine | 590 Historic Hwy 441 Lower Level, Demorest, GA 30535 | 2013-12-18 |
| Find all providers in zip 30535 | ||||
| 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 |
|---|---|---|---|---|
| 1851372361 | Northwest Diagnostic Imaging, Inc | Radiology | 638 441 Historic Hwy N, Suite D, Demorest, GA 30535-4566 | 2005-11-10 |
| 1942432646 | Open Mri of Georgia, Inc | Radiology | 638 441 Historic Hwy N, Suite D, Demorest, GA 30535-4566 | 2009-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326650136 | Tbi Diagnostic Centers of Georgia | Radiology | 4294 Memorial Dr Ste D, Decatur, GA 30032-1226 | 2020-08-21 |
| 1912464702 | Vickie Consuella71 Bush | Radiology | 3701 Bermuda Run Dr, Valdosta, GA 31605-1059 | 2019-02-27 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1578061636 | Subspecialty Imaging, LLC | Radiology | 1495 Hickory Flat Hwy Ste 150, Canton, GA 30115-4229 | 2018-01-24 |
| 1205354693 | Zenith Radiology LLC | Radiology | 1059 Windermere Xing, Cumming, GA 30041-6104 | 2017-09-06 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| 1902346422 | Allegiance Imaging and Radiology LLC | Radiology | 900 Thornton Rd, Ste A, Lithia Springs, GA 30122-2641 | 2017-03-02 |
| 1518406743 | Flexogenix Georgia PC | Radiology | 4600 Roswell Rd Unit E210, Sandy Springs, GA 30342-3197 | 2017-02-21 |
| 1649727215 | Metro Imaging Cumming, LLC | Radiology | 4150 Deputy Bill Cantrell Memorial Road, Cumming, GA 30040 | 2016-09-01 |
| Find all providers with the same taxonomy | ||||
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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.