Organization Active NPI

Medical Oncology Associastes of Augusta

  • Specialist
  • Augusta, GA
National Provider Identifier
1114931946
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
026400 Issued in GA
Legal business name
MEDICAL ONCOLOGY ASSOCIASTES OF AUGUSTA
Practice address
1348 Walton Way
Ste 6700
Augusta, GA 30901-5104
Phone
(706) 722-4245
Fax
(706) 722-6652
NPI assigned
Jul 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Glenda Hall
Title
Business Office Manager
Phone
(706) 722-4245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 026400 GA Primary

Addresses

Primary practice location

1348 Walton Way
Ste 6700
Augusta, GA 30901-5104

Mailing address

1348 Walton Way
Ste 6700
Augusta, GA 30901-5104
Phone (706) 722-4245

Other identifiers 2

IdentifierTypeStateIssuer
00288593GMedicaidGA
G26400MedicaidSC

National Provider Directory

National Provider Directory

Locations

1348 Walton Way
Ste 6700
Augusta, GA 30901
Phone (706) 722-4245

5110 Woodside Executive Ct
#A
Aiken, SC 29803
Phone (706) 722-4245

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114931946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 WALTON WAY",
            "address_2": "STE 6700",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309015104",
            "telephone_number": "706-722-4245",
            "fax_number": "706-722-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 WALTON WAY",
            "address_2": "STE 6700",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309015104",
            "telephone_number": "706-722-4245",
            "fax_number": "706-722-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ONCOLOGY ASSOCIASTES OF AUGUSTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "706-722-4245",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "026400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00288593G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G26400",
            "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 Aug 22, 2020; 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.