P E T IMAGING OF GWINNETT LLC (NPI# 1841285392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841285392 |
| Entity Type | Organization |
| Organization Name | P E T IMAGING OF GWINNETT LLC |
| Other Organization Name | TRIDENT PET OF GWINNETT |
| Practice Address |
545 Old Norcross Rd Ste 200 Lawrenceville GA 30045-3389 |
| Mailing Address |
1275 Highway 54 W Ste 103 Fayetteville GA 30214-4549 |
| Practice Telephone | 7707193754 |
| Practice Fax Number | 7707193804 |
| Mailing Telephone | 7706922371 |
| Mailing Fax Number | 7706922373 |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2012-04-10 |
| Authorized Official Name | GUY A MESSER (CFO) |
| Authorized Official Telephone | 7706922371 |
| Is Organization Subpart | Y |
| Parent Organization Name | TRIDENT MOLECULAR IMAGING, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Trident PET of Gwinnett | Doing Business As Name - Organization |
| Trident PET of Gwinnett | Doing Business As Name - Organization |
| Street Address |
545 OLD NORCROSS RD STE 200 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30045-3389 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104818764 | Ivory Myrick Bryant | Speech-Language Pathologist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2005-08-19 |
| 1134772502 | Alexandra Juliet Bass | Speech-Language Pathologist | 545 Old Norcross Rd, Lawrenceville, GA 30046-3389 | 2019-07-24 |
| 1689133985 | Nichole Hammer | Speech-Language Pathologist | 545 Old Norcross Rd, Lawrenceville, GA 30046-3389 | 2019-03-16 |
| 1861906075 | Jessica Okpara | Nurse Practitioner | 545 Old Norcross Rd, Lawrenceville, GA 30046-3389 | 2017-11-27 |
| 1568903722 | Adaky Chidundo Taylor | Physician Assistant | 545 Old Norcross Rd, #300, Lawrenceville, GA 30046-3389 | 2017-03-20 |
| 1538617543 | Nmamah K Sinlah | Speech-Language Pathologist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2016-09-19 |
| 1124574025 | Sarah Elisabeth Jones | Speech-Language Pathologist | 545 Old Norcross Rd, Suite 200, Lawrenceville, GA 30046-3389 | 2016-08-30 |
| 1528418654 | Pamela Willis | Speech-Language Pathologist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2016-06-20 |
| 1578912853 | Matthew William Nagle | Physical Therapist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2016-06-08 |
| 1417304114 | Henley Slepyan | Speech-Language Pathologist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2016-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285104315 | Shalanda Monique Booker | Counselor | 2940 Emerald Springs Drive, Lawrenceville, GA 30045 | 2018-12-02 |
| 1669957320 | Chantelle S Fuller | Behavioral Analyst | 805 Donington Cir, Lawrenceville, GA 30045 | 2018-09-28 |
| 1356836035 | Gad Health Care LLC | Home Health | 1140 Great Oaks Dr, Lawrenceville, GA 30045 | 2018-06-26 |
| 1346668662 | Eca Optical, LLC | Eyewear Supplier (Equipment, not the service) | 601-a Professional Drive, Ste 170, Lawrenceville, GA 30045 | 2014-04-03 |
| 1598102733 | Selena Fuller | Nurse Practitioner | 181 South Clayton Street, Lawrenceville, GA 30045 | 2013-05-29 |
| 1942555982 | Vida Michele James-bryant | Community Health Worker | 1309 Avington Glen Dr, Lawrenceville, GA 30045 | 2012-07-16 |
| 1770840639 | Rebecca Vinson D'angelo | Occupational Therapist | 1518 Great Shoals Cir, Lawrenceville, GA 30045 | 2012-04-17 |
| 1427346774 | Amanda Michelel Woods | Psychologist | 285 South Perry Street, Lawrenceville, GA 30045 | 2011-07-20 |
| 1790070563 | M & G Pharmacy Inc | Pharmacy | 100 Hurricane Shoals Rd Suite F, Lawrenceville, GA 30045 | 2011-06-09 |
| 1306146154 | Thanh Dau | Optometrist | 1250 Scenic Highway, Ste 1268, Lawrenceville, GA 30045 | 2010-10-27 |
| Find all providers in zip 30045 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770022360 | First Look Mri, LLC | Radiology | 1980 Friendship Rd, Suite 102, Hoschton, GA 30548-4154 | 2017-02-16 |
| 1235462235 | Gerald Eugene Caplan | Radiology | 1 Pickett Cir, Savannah, GA 31405-5622 | 2009-09-09 |
| 1487887766 | Justin Wilson Mcclain | Radiology | 1364 Clifton Rd Ne Ste D-112, Atlanta, GA 30322-1059 | 2009-09-02 |
| 1205075041 | Sunit Sebastian | Radiology | 1231 Clairmont Rd Apt 26c, Decatur, GA 30030-1242 | 2009-02-18 |
| 1669693768 | Raghava A Bhaskaran | Radiology | 606 Academy Ave, Dublin, GA 31021-5253 | 2007-05-02 |
| 1053497826 | Rockdale Diagnostics, LLC | Radiology | 1700 Honey Creek Commons Se, Conyers, GA 30013-5826 | 2006-10-27 |
| 1013099001 | Jagadishwar Devkota | Radiology | 20 Winged Foot Dr, Augusta, GA 30907-9140 | 2006-10-19 |
| 1235224346 | Southern Radiology Services | Radiology | 606 Academy Avenue, Dublin, GA 31021 | 2006-10-04 |
| 1952419012 | South Georgia Radiology Consultants, PC | Radiology | 5843 Deosta Dr, Lake Park, GA 31636-3405 | 2006-08-29 |
| 1265540561 | Timothy Thomas Ramsey Jr. | Radiology | 2905 Premiere Pkwy, Ste 310, Duluth, GA 30097-5247 | 2006-08-27 |
| Find all providers with the same taxonomy | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30045 |
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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.