NPIMap

Organization Active NPI

Csra General and Oncology Surgical LLC

  • Surgical Oncology Physician
  • Augusta, GA
National Provider Identifier
1063749299
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
029298 Issued in GA
Legal business name
CSRA GENERAL AND ONCOLOGY SURGICAL LLC
Practice address
2320 Wrightsboro Rd
Augusta, GA 30904-6233
Phone
(706) 737-7922
Fax
(706) 737-7968
NPI assigned
Nov 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Authorized official

Name
Mr. Jarmaur Stallings
Title
Practice Manager
Phone
(706) 737-7922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086X0206X 029298 GA Primary

Addresses

Primary practice location

2320 Wrightsboro Rd
Augusta, GA 30904-6233

Mailing address

2320 Wrightsboro Rd
Augusta, GA 30904-6233
Phone (706) 737-7922

Other identifiers 2

IdentifierTypeStateIssuer
000349907BMedicaidGA
GP3922MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1063749299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 WRIGHTSBORO RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046233",
            "telephone_number": "706-737-7922",
            "fax_number": "706-737-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 WRIGHTSBORO RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046233",
            "telephone_number": "706-737-7922",
            "fax_number": "706-737-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSRA GENERAL AND ONCOLOGY SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "STALLINGS",
        "authorized_official_first_name": "JARMAUR",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "706-737-7922",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": "GA",
            "license": "029298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000349907B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3922",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.