NPIMap

Organization Active NPI

21St Centrury Oncology LLC

Doing business as Premier Urology

  • Urology Physician
  • North Fort Myers, FL
National Provider Identifier
1255574190
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
21ST CENTRURY ONCOLOGY LLC
Doing business as
Premier Urology
Practice address
18900 N Tamiami TRL
Suite A12
North Fort Myers, FL 33903-7312
Phone
(239) 931-7342
Fax
(239) 931-7385
NPI assigned
Apr 8, 2009
Last updated
Jul 12, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
RADIATION THERAPY SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Authorized official

Name
Kim Commins
Title
Ceo
Phone
(239) 931-7277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

18900 N Tamiami TRL
Suite A12
North Fort Myers, FL 33903-7312

Mailing address

2234 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other identifiers 1

IdentifierTypeStateIssuer
CE7138OtherFLRAILROAD MEDICARE

Other names 1

  • Premier Urology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000663 FL Part B Supplier - Clinic/Group Practice 9830082882 Receives reassigned benefits from 314 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
James W Orr Jr MD72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

18900 N Tamiami Trl
Ste A12
North Fort Myers, FL 33903
Phone (239) 458-0168

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": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562889600000",
    "number": "1255574190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "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": "18900 N TAMIAMI TRL",
            "address_2": "SUITE A12",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339037312",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "21ST CENTRURY ONCOLOGY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADIATION THERAPY SERVICES INC",
        "enumeration_date": "2009-04-08",
        "last_updated": "2019-07-12",
        "status": "A",
        "authorized_official_last_name": "COMMINS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "239-931-7277"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CE7138",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Urology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.