NORTHWEST DIAGNOSTIC IMAGING, INC (NPI# 1922089713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922089713 |
| Entity Type | Organization |
| Organization Name | NORTHWEST DIAGNOSTIC IMAGING, INC |
| Other Organization Name | BRUNSWICK DIAGNOSTIC IMAGING, LLC |
| Practice Address |
1111 Glynco Pkwy Brunswick GA 31525-7921 |
| Mailing Address |
Po Box 932391 Atlanta GA 31193-2391 |
| Practice Telephone | 9122618890 |
| Practice Fax Number | 9122610342 |
| Mailing Telephone | 6783935600 |
| Mailing Fax Number | 7703009018 |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2008-05-20 |
| 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 | US DEPARTMENT OF LABOR | 22687081 | 01 |
| GA | RAILROAD MEDICARE | CA0798 | 01 |
| GA | RAILROAD MEDICARE | DA0357 | 01 |
| GA | RAILROAD MEDICARE | CH7801 | 01 |
| Other Name | Type Code |
|---|---|
| Brunswick Diagnostic Imaging, 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 |
1111 GLYNCO PKWY |
| City | BRUNSWICK |
| State | GA |
| Zip Code | 31525-7921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639562978 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 1111 Glynco Pkwy, Suite 30 - A Summit Professional Plaza I, Brunswick, GA 31525-7921 | 2015-03-11 |
| 1487047726 | Optim Orthopedics, LLC | Orthopaedic Surgery | 1111 Glynco Pkwy, Suite 30 - A Summit Professional Plaza I, Brunswick, GA 31525-7921 | 2015-03-11 |
| 1376960179 | Joseph Durant | Specialist | 1111 Glynco Pkwy, Ste. 400, Brunswick, GA 31525-7921 | 2014-03-19 |
| 1760815880 | Kendra Curry | Social Worker | 1111 Glynco Pkwy, Bldg 2, Suite 200, Brunswick, GA 31525-7921 | 2013-08-12 |
| 1144575168 | Karah Lynn Brown | Physician Assistant | 1111 Glynco Pkwy, #2-100, Brunswick, GA 31525-7921 | 2012-07-16 |
| 1659643955 | Costrini & Meadows PC | Internal Medicine | 1111 Glynco Pkwy, Suite 410, Brunswick, GA 31525-7921 | 2012-02-01 |
| 1285917401 | Micah Henderson Lancaster | Physician Assistant | 1111 Glynco Pkwy, Building 1, Suite 20, Brunswick, GA 31525-7921 | 2011-09-23 |
| 1114215498 | Florida Bracing Centers, Inc. | Prosthetic/Orthotic Supplier | 1111 Glynco Pkwy, Building 2, Suite 110, Brunswick, GA 31525-7921 | 2011-07-20 |
| 1801105275 | Dublin Vamc | Clinic/Center | 1111 Glynco Pkwy, Summit Professional Plaza, Suite 200, Brunswick, GA 31525-7921 | 2010-10-01 |
| 1538495999 | Neurological Institute of Atlanta | Psychiatry & Neurology | 1111 Glynco Pkwy, Ste 400, Brunswick, GA 31525-7921 | 2009-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063905990 | Jonathon Wesley Capps | Physician Assistant | 1111 Glynco Pkwy Bldg 1, Ste 10, Brunswick, GA 31525 | 2018-06-14 |
| 1366993628 | Hands Down Muscle Restoration, Inc | Homeopath | 1212 Chapel Crossing Road, Brunswick, GA 31525 | 2016-10-20 |
| 1619424173 | Jebediah S Christy Dds - Brunswick Pllc | Dentist | 11455 Canal Crossing, Brunswick, GA 31525 | 2016-09-01 |
| 1831545508 | Heller Family Medicine, LLC | General Practice | 208 Scranton Connector Ste 120, Brunswick, GA 31525 | 2016-05-11 |
| 1437525391 | Natisha Danielle Hill | Occupational Therapy Assistant | 138 Wingefield Commons Drive, Brunswick, GA 31525 | 2015-08-14 |
| 1811269632 | Solar Family Practice | Family Medicine | 122 Scranton Connector, Suite 112, Brunswick, GA 31525 | 2012-02-09 |
| 1700187895 | Chetan Patel | Pharmacist | 12 Woodfall Ct, Brunswick, GA 31525 | 2010-11-05 |
| 1194914275 | Dialysis of Golden Isles, LLC | Clinic/Center | 475 Gateway Center Blvd, Brunswick, GA 31525 | 2007-10-15 |
| 1902939325 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Frazier Street, Brunswick, GA 31525 | 2007-03-14 |
| 1609909498 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 115 Frazier Road, Brunswick, GA 31525 | 2007-03-13 |
| Find all providers in zip 31525 | ||||
| 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 |
|---|---|---|---|---|
| 1255438974 | Southeast Georgia Open Mri LLC | Radiology | 1103 Fountain Lake Drive, Brunswick, GA 31525 | 2006-09-17 |
| 1982642732 | Mark M Eule | Radiology | 123 Medical Center Drive, Brunswick, ME 04011-2652 | 2006-06-03 |
| 1912997859 | Terry L Reynolds | Radiology | 2415 Parkwood Drive, Brunswick, GA 31520-4722 | 2005-10-23 |
| 1396731733 | Donald H Manning | Radiology | 403 Eh Court, Brunswick, GA 31520-4743 | 2005-09-21 |
| 1942294087 | Radiology Consultants PC | Radiology | 2415 Parkwood Dr, Brunswick, GA 31520-4722 | 2005-09-05 |
| 1013911841 | Philip S Crichton | Radiology | 123 Medical Center Dr, Brunswick, ME 04011-2652 | 2005-06-09 |
| 1164830139 | Radiology Consultants of Maine, LLC | Radiology | 123 Medical Center Dr, Brunswick, ME 04011-2652 | 2014-07-23 |
| 1720491509 | Michael Talarico | Radiology | 123 Medical Center Dr, Brunswick, ME 04011-2652 | 2014-06-09 |
| 1992144976 | Thomas D Cesca | Radiology | 123 Medical Center Dr, Brunswick, ME 04011-2652 | 2013-06-23 |
| 1396802120 | Barbara A Luke | Radiology | 123 Medical Center Dr, Brunswick, ME 04011-2652 | 2007-01-02 |
| Find all providers in BRUNSWICK | ||||
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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.