CDC Northside – Diagnostic Radiology Physician, NPI 1598081093
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CDC Northside
7500 VETERANS PKWY STE B
COLUMBUS, GA 319092525
Phone: (706) 323-7622
Fax: (706) 256-3454
Type: Location
Rice Box, Atlanta BeltLine Eastside Trail, Atlanta, Georgia, 30308, United States
ATLANTA, GA 311931077
Phone: (706) 256-3450
Fax: (706) 256-3454
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 7 Medicare enrollment records; no due dates published yet.
Enrollment records
7
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040429001218 | O | Clinic/Group Practice | GA | TBD |
| O20230508001015 | O | Clinic/Group Practice | AL | TBD |
| O20230925002886 | O | Clinic/Group Practice | SC | TBD |
| O20230925003153 | O | Clinic/Group Practice | WV | TBD |
| O20231019002674 | O | Clinic/Group Practice | TX | TBD |
| O20231214000332 | O | Clinic/Group Practice | MI | TBD |
| O20231218002627 | O | Clinic/Group Practice | MT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31909)
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