Active NPI
Radiation Oncologists South East, P.C.
- Radiation Oncology Physician
- Thomasville, GA
National Provider Identifier
1124072053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- Legal business name
- RADIATION ONCOLOGISTS SOUTH EAST, P.C.
- Practice address
- 116 Mimosa Dr
Thomasville, GA 31792-6605 - Phone
- (229) 228-2982
- Fax
- (229) 551-8784
- NPI assigned
- May 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Mary Jo Harris
- Title
- Manager
- Phone
- (229) 228-2982
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | Primary |
Addresses
Primary practice location
116 Mimosa Dr
Thomasville, GA 31792-6605
Mailing address
116 Mimosa Dr
Thomasville, GA 31792-6605
Phone (229) 228-2982
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100914000692 | GA | Part B Supplier - Clinic/Group Practice | 7113042177 |
Receives reassigned benefits from 2 practitioners Practice locations: Moultrie, GA; Thomasville, GA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Radiation Oncology Physician
- Thomasville, GA
- NPI 1053392217
GA, Radiation Oncology
-
- Radiation Oncology Physician
- Thomasville, GA
- NPI 1407837669
GA, Radiation Oncology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1269302400000",
"number": "1124072053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 MIMOSA DR",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317926605",
"telephone_number": "229-228-2982",
"fax_number": "229-551-8730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 MIMOSA DR",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317926605",
"telephone_number": "229-228-2982",
"fax_number": "229-551-8784"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RADIATION ONCOLOGISTS SOUTH EAST, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-22",
"last_updated": "2010-03-23",
"status": "A",
"authorized_official_last_name": "HARRIS",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "JO",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "229-228-2982",
"authorized_official_name_prefix": "Mrs."
},
"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 Thomasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; 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.