NPIMap

Organization Active NPI

Cochise Oncology LLC

  • Radiation Oncology Physician
  • Sierra Vista, AZ
National Provider Identifier
1013954858
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
COCHISE ONCOLOGY LLC
Practice address
5151 E Highway 90
Sierra Vista, AZ 85635-2436
Phone
(520) 803-6644
Fax
(520) 459-3193
NPI assigned
Jun 1, 2006
Last updated
Feb 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Janet Marie Nettleton, M.D.NPI 1285698720
Title
Director
Phone
(520) 559-3684

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X NU
Radiation Oncology Physician 2085R0001X NU Primary

Addresses

Primary practice location

5151 E Highway 90
Sierra Vista, AZ 85635-2436

Mailing address

PO Box 1418
Sierra Vista, AZ 85636-1418
Phone (520) 803-6644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060628000183 AZ Part B Supplier - Clinic/Group Practice 2567474083 Receives reassigned benefits from 10 practitioners
Practice locations: Sierra Vista, AZ
O20190826003443 AZ Part B Supplier - Pharmacy 2567474083 Practice locations: Sierra Vista, AZ

National Provider Directory

National Provider Directory

Locations

302 El Camino Real
Ste 1
Sierra Vista, AZ 85635
Phone (520) 459-4477

5151 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 803-6644

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1013954858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1418",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856361418",
            "telephone_number": "520-803-6644",
            "fax_number": "520-459-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 E HIGHWAY 90",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352436",
            "telephone_number": "520-803-6644",
            "fax_number": "520-459-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COCHISE ONCOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "NETTLETON",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "520-559-3684",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.