NPIMap

Organization Active NPI

NSH Cancer Institute Professional Services a LLC

  • Hematology & Oncology Physician
  • Atlanta, GA
National Provider Identifier
1215288378
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
NSH CANCER INSTITUTE PROFESSIONAL SERVICES A LLC
Practice address
5670 Peachtree Dunwoody Rd NE
Suite 1100
Atlanta, GA 30342-1699
Phone
(404) 851-2300
NPI assigned
Sep 28, 2012
Last updated
Aug 17, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHSIDE HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Authorized official

Name
Amy E Fouts
Title
Chief Compliance Officer
Phone
(404) 851-6968

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Hematology & Oncology Physician 207RH0003X NU Primary

Addresses

Primary practice location

5670 Peachtree Dunwoody Rd NE
Suite 1100
Atlanta, GA 30342-1699

Mailing address

1100 Johnson Fy Rd NE
Sandy Springs, GA 30342-1709

Other names 1

  • NSH CIPS A Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130107000162 GA Part B Supplier - Clinic/Group Practice 1557514247 Receives reassigned benefits from 66 practitioners
Practice locations: Canton, GA; Stockbridge, GA; Lake Spivey, GA; Decatur, GA; Cumming, GA; Conyers, GA; Atlanta, GA; Alpharetta, GA

National Provider Directory

National Provider Directory
Part of
Northsidedunwoody Surg

Member of 1

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

Locations

1100 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 300-2476

Practitioners & affiliated clinicians

Practitioners 69

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 69

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": "1786924800000",
    "number": "1215288378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FY RD NE",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303421709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5670 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 1100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421699",
            "telephone_number": "404-851-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NSH CANCER INSTITUTE PROFESSIONAL SERVICES A LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHSIDE HOSPITAL, INC.",
        "enumeration_date": "2012-09-28",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A",
        "authorized_official_last_name": "FOUTS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "404-851-6968"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "NSH CIPS A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 17, 2026; 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.