Organization Active NPI

South Arkansas RT Associates LLC

  • Radiation Oncology Physician
  • El Dorado, AR
National Provider Identifier
1104125616
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
SOUTH ARKANSAS RT ASSOCIATES LLC
Practice address
503 Thompson Ave
El Dorado, AR 71730-4555
Phone
(870) 864-0318
Fax
(870) 862-9660
NPI assigned
Mar 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Authorized official

Name
Mr. Armando J Rosell
Title
Authorized Official
Phone
(405) 702-0888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

503 Thompson Ave
El Dorado, AR 71730-4555

Mailing address

236 NW 62ND St
Oklahoma City, OK 73118-7422
Phone (405) 775-4420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110827000008 AR Part B Supplier - Clinic/Group Practice 3577733641 Receives reassigned benefits from 1 practitioner
Practice locations: El Dorado, AR

National Provider Directory

National Provider Directory

Locations

803 Thompson Ave
AR 71730

503 Thompson Ave
El Dorado, AR 71730
Phone (870) 854-0318

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1104125616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 NW 62ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731187422",
            "telephone_number": "405-775-4420",
            "fax_number": "405-841-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 THOMPSON AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304555",
            "telephone_number": "870-864-0318",
            "fax_number": "870-862-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ARKANSAS RT ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-23",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "ROSELL",
        "authorized_official_first_name": "ARMANDO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "405-702-0888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.