NPIMap

Organization Active NPI

Integrated Community Oncology Network LLC

  • Radiation Oncology Physician
  • Jacksonville, FL
National Provider Identifier
1366477531
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC
Practice address
1235 San Marco Blvd
Suite 100
Jacksonville, FL 32207-8554
Phone
(904) 202-7020
Fax
(904) 202-7029
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Authorized official

Name
Shyam B Paryani, MD
Title
Director
Phone
(904) 309-8680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

1235 San Marco Blvd
Suite 100
Jacksonville, FL 32207-8554

Mailing address

PO Box 19675
Jacksonville, FL 32245-9675
Phone (904) 309-8680

Other identifiers 3

IdentifierTypeStateIssuer
94890OtherFLBLUE CROSS BLUE SHIELD
DC6938OtherFLMEDICARE RAILROAD
273427312MedicaidFL

Other names 1

  • Florida Radiation Oncology Group Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343692800000",
    "number": "1366477531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19675",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322459675",
            "telephone_number": "904-309-8680",
            "fax_number": "904-345-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 SAN MARCO BLVD",
            "address_2": "SUITE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078554",
            "telephone_number": "904-202-7020",
            "fax_number": "904-202-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-07-31",
        "status": "A",
        "authorized_official_last_name": "PARYANI",
        "authorized_official_first_name": "SHYAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-309-8680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "94890",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DC6938",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273427312",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Radiation Oncology Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.