Organization Active NPI

Integrated Community Oncology Network LLC

Doing business as Florida Radiation Oncology Group

  • Radiation Oncology Physician
  • Palatka, FL
National Provider Identifier
1518986926
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC
Doing business as
Florida Radiation Oncology Group
Practice address
600 Zeagler Dr
Suite 2
Palatka, FL 32177-3811
Phone
(386) 325-8140
Fax
(904) 350-0032
NPI assigned
Jul 18, 2006
Last updated
Jan 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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 Physician 2085R0001X NU Primary

Addresses

Primary practice location

600 Zeagler Dr
Suite 2
Palatka, FL 32177-3811

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
94890OtherFLBLUE CROSS BLUE SHIELD
DC6938OtherFLMEDICARE RAILROAD
273427303MedicaidFL

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": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1518986926",
    "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": "904-345-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ZEAGLER DR",
            "address_2": "SUITE 2",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773811",
            "telephone_number": "386-325-8140",
            "fax_number": "904-350-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2015-01-21",
        "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": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "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": "273427303",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Radiation Oncology Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.