NPIMap

Organization Active NPI

LW Gwinnett County Radiation

  • Specialist
  • Lawrenceville, GA
National Provider Identifier
1104091602
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
46327 Issued in GA
Legal business name
LW GWINNETT COUNTY RADIATION
Practice address
311 Philip Blvd
Lawrenceville, GA 30045-8733
Phone
(770) 995-3000
Fax
(770) 995-1427
NPI assigned
Apr 25, 2008
Organization subpart
Yes
Parent organization
RADIOTHERAPY CLINICS OF GEORGIA,LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Tammie Laviscount
Title
Contract Analyst
Phone
(770) 682-2080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 46327 GA Primary

Addresses

Primary practice location

311 Philip Blvd
Lawrenceville, GA 30045-8733

Mailing address

53 Perimeter Ctr E
Suite 500
Atlanta, GA 30346-2294
Phone (770) 682-2080

Other names 1

  • Radiotherapy Clinics of Georgia Other name

National Provider Directory

National Provider Directory
Tax ID family
Radiotherapy Clinics of Georgiallc7 organizations share this tax ID, including this one
Part of
Radiotherapy Clinics of Georgiallc

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1104091602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 PERIMETER CTR E",
            "address_2": "SUITE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303462294",
            "telephone_number": "770-682-2080",
            "fax_number": "678-587-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PHILIP BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300458733",
            "telephone_number": "770-995-3000",
            "fax_number": "770-995-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LW GWINNETT COUNTY RADIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADIOTHERAPY CLINICS OF GEORGIA,LLC",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "LAVISCOUNT",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_title_or_position": "CONTRACT ANALYST",
        "authorized_official_telephone_number": "770-682-2080"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "46327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiotherapy Clinics of Georgia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.