NPIMap

Individual provider Active NPI

Geetha Shiva Rao, MD

  • Radiation Oncology Physician
  • Fayetteville, GA
National Provider Identifier
1255370375
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
54115 Issued in GA
Practice address
1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone
(770) 719-5850
Fax
(770) 719-5849
NPI assigned
Jun 5, 2006
Last updated
May 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 54115 GA Primary

Addresses

Primary practice location

1255 Highway 54 W
Fayetteville, GA 30214-4526

Mailing address

255 Professional CT
Riverdale, GA 30274-2531
Phone (770) 907-0554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050615000906 GA Practitioner - Radiation Oncology 9133163652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Duke University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Radiation Oncology, PCGroup PAC ID 2163325812, 8 clinicians

Practice addresses (Care Compare)

1255 Hwy 54 W
Fayetteville, GA 30214-4526
Phone (770) 719-7071

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
54115GAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newnan Regional Radiation Therapy Center, Inc. Radiation Oncology Current Accepting new patients
Griffin Regional Radiation Therapy Center, Inc. Radiation Oncology Current Accepting new patients
Therapeutic Radiation Oncology, PC Radiation Oncology CurrentSince Apr 7, 2005 Accepting new patients
Associates in Radiation Medicine, PC Radiation Oncology PastSince Jul 1, 2018 Accepting new patients
Radiation Oncology Alliance Radiation Oncology Past Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1800 Hospital South Dr
Austell, GA 30106
Phone (770) 793-7196

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1136 Cleveland Ave
Ste 119
East Point, GA 30344
Phone (404) 305-4580

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

725 S 8th St
Griffin, GA 30224
Phone (404) 222-9411

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

255 Professional Ct
Riverdale, GA 30274
Phone (770) 907-0554

275 Professional Ct
#B
Riverdale, GA 30274
Phone (770) 907-0554

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Piedmont Fayette Hospital IncFayetteville, GA, CCN 110215 Hospital Corporate Director Jul 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1255370375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 PROFESSIONAL CT",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742531",
            "telephone_number": "770-907-0554",
            "fax_number": "770-907-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144526",
            "telephone_number": "770-719-5850",
            "fax_number": "770-719-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "GEETHA",
        "middle_name": "SHIVA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "GA",
            "license": "54115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.