VRD Radiation Oncology, PC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

VRD RADIATION ONCOLOGY, PC

Practice address

12303 De Paul Dr
Dept. of Radiation Oncology
Bridgeton, MO 63044-2512

Phone

(314) 344-6090

Fax

(314) 344-6093

NPI assigned

Aug 7, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Venkata R Devineni, MDNPI 1972511590

Title

President

Phone

(314) 344-6090

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

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.

• Venkata R Devineni, MD

  • Radiation Oncology Physician
  • Bridgeton, MO
  • NPI 1972511590
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376552323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 BARNBRIDGE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631313130",
            "telephone_number": "314-344-6090",
            "fax_number": "314-344-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 DE PAUL DR",
            "address_2": "DEPT. OF RADIATION ONCOLOGY",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442512",
            "telephone_number": "314-344-6090",
            "fax_number": "314-344-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VRD RADIATION ONCOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEVINENI",
        "authorized_official_first_name": "VENKATA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-344-6090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clayton R Vogt
• Julia Ann Vollmer
• Jen Volpitto, M.A.,PLPC
• Amanda Marie Volz
• Kyle Vost, PHARMD
• Zoe Marie Wadsworth, APRN-CPNP
• Colleen Wagener
• Nikita Wagle, MD
• Julia Wagner, FNP-C
• Kevin Matthew Wagner, MD PT CERT MDT

• Radiation Oncology Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Radiation Oncology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.