Organization Active NPI

West Virginia Radiation Therapy Services Inc

  • Radiation Oncology Physician
  • Lewisburg, WV
National Provider Identifier
1164674156
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
WEST VIRGINIA RADIATION THERAPY SERVICES INC
Practice address
187 Skylar Dr
Lewisburg, WV 24901-9359
Phone
(304) 647-3500
Fax
(304) 647-4446
NPI assigned
Oct 21, 2008
Organization subpart
Yes
Parent organization
GENESISCARE USA OF FLORIDA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Authorized official

Name
Shaden Marzouk
Title
President
Phone
(239) 931-7254

Specialties & licenses 1

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

Addresses

Primary practice location

187 Skylar Dr
Lewisburg, WV 24901-9359

Mailing address

1419 SE 8TH Ter Ste 200
Cape Coral, FL 33990-3213
Phone (239) 931-7342

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090304000510 WV Part B Supplier - Clinic/Group Practice 8527124205 Receives reassigned benefits from 2 practitioners
Practice locations: Lewisburg, WV; Princeton, WV

National Provider Directory

National Provider Directory

Locations

200 Arh Ln
#103B
Covington, VA 24426
Phone (540) 862-6662

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": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1164674156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 SE 8TH TER STE 200",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903213",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 SKYLAR DR",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019359",
            "telephone_number": "304-647-3500",
            "fax_number": "304-647-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VIRGINIA RADIATION THERAPY SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESISCARE USA OF FLORIDA INC",
        "enumeration_date": "2008-10-21",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "MARZOUK",
        "authorized_official_first_name": "SHADEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-931-7254"
    },
    "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 Lewisburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.