CANTON SPECIALTY IMAGING, LLC (NPI# 1457640831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457640831 |
| Entity Type | Organization |
| Organization Name | CANTON SPECIALTY IMAGING, LLC |
| Practice Address |
200 Oakside Ln Suite A Canton GA 30114-6416 |
| Practice Telephone | 7704791945 |
| Practice Fax Number | 7704791948 |
| Mailing Telephone | 7704791945 |
| Mailing Fax Number | 7704791948 |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2011-04-06 |
| Authorized Official Name | DR. BRADLEY R PETERS (MEMBER/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7704791945 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 051890 | GA | Other Service Providers |
| Street Address |
200 OAKSIDE LN SUITE A |
| City | CANTON |
| State | GA |
| Zip Code | 30114-6416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659374262 | Bradley Robert Peters | Radiology | 200 Oakside Ln, Ste A, Canton, GA 30114-6416 | 2005-05-27 |
| 1306086228 | Kennestone Heart Physicians Group | Internal Medicine | 200 Oakside Ln, Suite D, Canton, GA 30114-6416 | 2009-03-05 |
| 1588774467 | Teru Kay Lapaquette | Obstetrics & Gynecology | 200 Oakside Ln, Suite D, Canton, GA 30114-6416 | 2006-08-30 |
| 1932155355 | Imaging Associates of Canton | Clinic/Center | 200 Oakside Ln, Suite A, Canton, GA 30114-6415 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184252595 | Peachtree Surgical Assistants Inc | Specialist | 59 Anderson Ave Apt 127, Canton, GA 30114-2330 | 2020-03-31 |
| 1841792611 | Medical Affiliates Inc | Specialist | 2000 Village Professional Dr Ste 200, Canton, GA 30114-8499 | 2018-03-07 |
| 1710421185 | Michele L Gash | Specialist | 4505 12th St Nw, Lower, Canton, OH 44708-3536 | 2016-12-05 |
| 1497202857 | Aultman Hospital | Specialist | 4650 Hills and Dales Road Nw, Canton, OH 44708-6221 | 2016-09-02 |
| 1033576970 | Stephanie Grimes | Specialist | 42522 Amherst Ct, Canton, MI 48187-2359 | 2016-01-22 |
| 1710384987 | Sonya Hess | Specialist | 1801 Scheider St. Ne, Canton, OH 44721-3349 | 2014-12-03 |
| 1235536145 | Courteney Vesco | Specialist | 1326 Sherrick Rd Se, Canton, OH 44707-3531 | 2014-11-21 |
| 1396154365 | Nephrology and Critical Care Pllc | Specialist | 48356 Wadebridge Dr, Canton, MI 48187-1225 | 2014-08-04 |
| 1093132599 | Nancy Miller | Specialist | 8340 Alton St, Canton, MI 48187-4228 | 2014-03-21 |
| 1225474307 | Anointed Healing | Specialist | 113 Mountain Brook Dr Ste 208, Canton, GA 30115-9057 | 2013-05-16 |
| Find all providers in CANTON | ||||
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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.