Cccnf - Lake Butler, LLC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

JR45707000 Issued in FL

Legal business name

CCCNF - LAKE BUTLER, LLC

Practice address

7765 S County Road 231
Lake Butler, FL 32054-5721

Phone

(386) 496-0900

Fax

(386) 496-0777

NPI assigned

Mar 15, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Stuart M. Bitting

Title

Evp

Phone

(615) 783-1253

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• FL Dept of Corrections - RMC Cancer Center Other name

Locations

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458000000000",
    "number": "1043671241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WOODMONT BLVD",
            "address_2": "SUITE 500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052245",
            "telephone_number": "615-467-7400",
            "fax_number": "615-467-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7765 S COUNTY ROAD 231",
            "city": "LAKE BUTLER",
            "state": "FL",
            "postal_code": "320545721",
            "telephone_number": "386-496-0900",
            "fax_number": "386-496-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCCNF - LAKE BUTLER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-15",
        "last_updated": "2016-03-15",
        "status": "A",
        "authorized_official_last_name": "BITTING",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "615-783-1253",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "JR45707000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RADIOACTIVE MATERIAL LICENSE",
            "identifier": "RAM LICENSE 4226-1",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FL Dept of Corrections - RMC Cancer Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tony Byrd
• Janna Toruno Caines, APRN
• Marta Anisia Castillo, M.D.
• Laura Caswell, APRN
• Allison Nicole Catarelli
• Kelly Melinda Chewning, ARNP
• Susan Child, LMHC
• Bailey Clark, COTA/L
• Kelly Darlene Clark, DC
• Lisa Cunningham, SLP

• All providers in Lake Butler, FL
• Radiation Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.