Integrated Community Oncology Network LLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC

Practice address

710 Lomax St
Jacksonville, FL 32204-4004

Phone

(904) 355-6583

Fax

(904) 355-4922

NPI assigned

Feb 20, 2008

Organization subpart

No

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

Authorized official

Name

Robert J Phelan

Title

Executive Director

Phone

(904) 363-2113

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• McIver Urological Clinic Doing business as

Locations

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1457529786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9143 PHILIPS HWY",
            "address_2": "SUITE 560",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322561348",
            "telephone_number": "904-363-7453",
            "fax_number": "904-538-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 LOMAX ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044004",
            "telephone_number": "904-355-6583",
            "fax_number": "904-355-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "PHELAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-363-2113"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC6938",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McIver Urological Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Integra Concierge Medicine
• Integrated Community Oncology Network LLC
• Integrated Community Oncology Network LLC
• Integrated Community Oncology Network LLC
• Integrated Community Oncology Network LLC
• Integrated Community Oncology Network LLC
• Integrated Community Oncology Network LLC
• Integrated Community Oncology Network LLC
• Integrated Community Oncology Network LLC
• Integrated Community Oncology Network LLC

• Urology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.