NPIMap

Organization Active NPI

East Jefferson Radiation Oncology, LLC

  • Radiation Oncology Physician
  • Metairie, LA
National Provider Identifier
1114977402
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
EAST JEFFERSON RADIATION ONCOLOGY, LLC
Practice address
4204 Houma Blvd
Metairie, LA 70006-2903
Phone
(504) 454-1724
Fax
(504) 455-4857
NPI assigned
May 10, 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
Ricky Stonicher
Title
Department Administrator
Phone
(504) 454-1724

Specialties & licenses 1

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

Addresses

Primary practice location

4204 Houma Blvd
Metairie, LA 70006-2903

Mailing address

4204 Houma Blvd
Suite 211
Metairie, LA 70006-2903
Phone (504) 454-1727

National Provider Directory

National Provider Directory

Locations

3800 Houma Blvd
Metairie, LA 70006
Phone (504) 491-7072

4204 Houma Blvd
Ste 100
Metairie, LA 70006
Phone (504) 454-1724

3800 Houma Blvd
Ste 240
Metairie, LA 70006

Practitioners & affiliated clinicians

Practitioners 6

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": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114977402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 HOUMA BLVD",
            "address_2": "SUITE 211",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062903",
            "telephone_number": "504-454-1727",
            "fax_number": "504-455-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4204 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062903",
            "telephone_number": "504-454-1724",
            "fax_number": "504-455-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST JEFFERSON RADIATION ONCOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STONICHER",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "DEPARTMENT ADMINISTRATOR",
        "authorized_official_telephone_number": "504-454-1724"
    },
    "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 Metairie, LA

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.