NPIMap

Organization Active NPI

NSH Cancer Institute Professional Services G, LLC

  • Hematology & Oncology Physician
  • Atlanta, GA
National Provider Identifier
1124379284
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
NSH CANCER INSTITUTE PROFESSIONAL SERVICES G, LLC
Practice address
1100 Johnson Ferry Rd NE
Suite 600
Atlanta, GA 30342-1709
Phone
(404) 851-6378
NPI assigned
Sep 28, 2012
Last updated
Oct 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Authorized official

Name
Jorge Hernandez
Title
VP of Admin Services and Cco
Phone
(404) 851-6378

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X Primary
Pharmacy 333600000X

Addresses

Primary practice location

1100 Johnson Ferry Rd NE
Suite 600
Atlanta, GA 30342-1709

Mailing address

308 Coliseum Dr
Suite 150
Macon, GA 31217-3865

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130128000225 GA Part B Supplier - Clinic/Group Practice 0840443164 Receives reassigned benefits from 172 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3330 Preston Ridge Rd
Ste 1100
Alpharetta, GA 30005

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

125 King Ave
Ste 200
Athens, GA 30606
Phone (706) 369-4478

320 Parkway Dr NE
Fl 2
Atlanta, GA 30312

308 Deep South Farm Rd
Ste 300
Blairsville, GA 30512

1505 Northside Blvd
Ste 4300
Cumming, GA 30041
Phone (770) 205-1331

4586 Timber Ridge Dr
Ste 200
Douglasville, GA 30135
Phone (770) 489-3513

134 Mountainside Village Pkwy
#100
Jasper, GA 30143

6300 Hospital Pkwy
Ste 300
Johns Creek, GA 30097
Phone (770) 623-8965

5700 Hillandale Dr
Ste 250
Lithonia, GA 30058
Phone (770) 981-5431

800 1st St
Ste 160
Macon, GA 31201
Phone (478) 633-3137

1045 Southcrest Dr
Ste 210
Stockbridge, GA 30281

Practitioners & affiliated clinicians

Practitioners 199

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.

View all 199

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1124379284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 COLISEUM DR",
            "address_2": "SUITE 150",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FERRY RD NE",
            "address_2": "SUITE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421709",
            "telephone_number": "404-851-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NSH CANCER INSTITUTE PROFESSIONAL SERVICES G, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "VP OF ADMIN SERVICES AND CCO",
        "authorized_official_telephone_number": "404-851-6378"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.