NPIMap

Organization Active NPI

Cancer Care Group, P.C.

  • Radiation Oncology Physician
  • Shelbyville, IN
National Provider Identifier
1164629077
Registry record updated Aug 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
CANCER CARE GROUP, P.C.
Practice address
2455 Intelliplex Dr
Shelbyville, IN 46176-8535
Phone
(317) 392-3211
Fax
(317) 715-6200
NPI assigned
Jul 3, 2007
Last updated
Aug 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2014

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

Authorized official

Name
Mr. Thomas C. Dugan, M.D.NPI 1336142827
Title
President
Phone
(317) 715-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X NU Primary

Addresses

Primary practice location

2455 Intelliplex Dr
Shelbyville, IN 46176-8535

Mailing address

6100 W 96TH St
Suite 125
Indianapolis, IN 46278-6005
Phone (317) 715-1800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000316 IN Part B Supplier - Clinic/Group Practice 1850295858 Receives reassigned benefits from 23 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Indianapolis, IN; Kokomo, IN; Lafayette, IN; Lebanon, IN; Logansport, IN; Mooresville, IN; Noblesville, IN; Peru, IN…

Other NPIs on the same Medicare enrollment 31

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

View all 31

National Provider Directory

National Provider Directory
Tax ID family
Cancer Care Group PC36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Locations

2455 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 421-1800

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": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407801600000",
    "number": "1164629077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 W 96TH ST",
            "address_2": "SUITE 125",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462786005",
            "telephone_number": "317-715-1800",
            "fax_number": "317-715-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 INTELLIPLEX DR",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768535",
            "telephone_number": "317-392-3211",
            "fax_number": "317-715-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CARE GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2014-08-12",
        "status": "A",
        "authorized_official_last_name": "DUGAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-715-1800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.