Organization Active NPI

Oak Ridge Radiation Oncology P LLC

  • Therapeutic Radiology Physician
  • Oak Ridge, TN
National Provider Identifier
1548586035
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Therapeutic Radiology PhysicianTaxonomy code 2085R0203X
License
MD0000025245 Issued in TN
Legal business name
OAK RIDGE RADIATION ONCOLOGY P LLC
Practice address
102 Vermont Ave
Oak Ridge, TN 37830-6402
Phone
(865) 835-4500
Fax
(865) 835-4503
NPI assigned
Apr 9, 2010
Last updated
Nov 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Authorized official

Name
Dr. Elliot Brin Navo, MDNPI 1023334000
Title
Ao
Phone
(865) 835-4500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Therapeutic Radiology Physician 2085R0203X MD0000025245 TN Primary

Addresses

Primary practice location

102 Vermont Ave
Oak Ridge, TN 37830-6402

Mailing address

PO Box 129
Flagler Beach, FL 32136-0129
Phone (865) 835-4500

Other identifiers 1

IdentifierTypeStateIssuer
Q032005MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100910000013 TN Part B Supplier - Clinic/Group Practice 8921123258 Receives reassigned benefits from 1 practitioner
Practice locations: Oak Ridge, TN

National Provider Directory

National Provider Directory

Locations

102 Vermont Ave
Oak Ridge, TN 37830
Phone (865) 835-4500

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1548586035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "321360129",
            "telephone_number": "865-835-4500",
            "fax_number": "865-835-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306402",
            "telephone_number": "865-835-4500",
            "fax_number": "865-835-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK RIDGE RADIATION ONCOLOGY P LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-09",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "NAVO",
        "authorized_official_first_name": "ELLIOT",
        "authorized_official_middle_name": "BRIN",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "865-835-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "TN",
            "license": "MD0000025245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q032005",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.