North State Cancer Specialty Inc

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

G73860 Issued in CA

Legal business name

NORTH STATE CANCER SPECIALTY INC

Practice address

2510 Airpark Dr
Suite 103
Redding, CA 96001

Phone

(530) 242-8822

Fax

(530) 242-0849

NPI assigned

Apr 25, 2006

Organization subpart

No

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

Authorized official

Name

Jed L Freeman, MD

Title

Pres

Phone

(530) 242-8822

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236038400000",
    "number": "1396701546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496084",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496084",
            "telephone_number": "530-241-0473",
            "fax_number": "530-241-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 AIRPARK DR",
            "address_2": "SUITE 103",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96001",
            "telephone_number": "530-242-8822",
            "fax_number": "530-242-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STATE CANCER SPECIALTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2009-03-03",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "JED",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "530-242-8822",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G73860",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35-056102F",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G738600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Norman Wall DO Incorporated
• Aaron Andrew Norman, DDS
• Andrew S Norman, DDS
• Tracy Ann Norman, RN
• North Point Community Services
• North State Family Counseling Center Inc
• North State Social Work & Psychotherapy Services Inc a Licen
• North State Surgery Centers LP
• North State Surgery Centers, LP
• North Valley Breast Clinic

• All providers in Redding, CA
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.