Organization Active NPI

Cancer Institute of Cape Girardeau, LLC

  • Radiation Oncology Clinic/Center
  • Cape Girardeau, MO
National Provider Identifier
1336228949
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology Clinic/CenterTaxonomy code 261QX0203X
Legal business name
CANCER INSTITUTE OF CAPE GIRARDEAU, LLC
Practice address
14 Doctors Park
Suite B
Cape Girardeau, MO 63703-4928
Phone
(573) 334-2230
Fax
(573) 651-6499
NPI assigned
Nov 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Authorized official

Name
Leslie Luttrell, ROCC
Title
Biller/Coder
Phone
(573) 331-5916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Clinic/Center 261QX0203X Primary

Addresses

Primary practice location

14 Doctors Park
Suite B
Cape Girardeau, MO 63703-4928

Mailing address

14 Doctors Park
Suite B
Cape Girardeau, MO 63703-4928
Phone (573) 334-2230

Other identifiers 1

IdentifierTypeStateIssuer
514063OtherMOHEALTHLINK PROVIDER ID

National Provider Directory

National Provider Directory

Locations

14 Doctors Park
Ste B
Cpe Girardeau, MO 63703
Phone (573) 334-2230

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": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1336228949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 DOCTORS PARK",
            "address_2": "SUITE B",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-2230",
            "fax_number": "573-651-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 DOCTORS PARK",
            "address_2": "SUITE B",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-2230",
            "fax_number": "573-651-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER INSTITUTE OF CAPE GIRARDEAU, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "LUTTRELL",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "BILLER/CODER",
        "authorized_official_telephone_number": "573-331-5916",
        "authorized_official_credential": "ROCC"
    },
    "taxonomies": [
        {
            "code": "261QX0203X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology, Radiation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROVIDER ID",
            "identifier": "514063",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.