Integrated Community Oncology Network LLC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC

Practice address

1677 Eagle Harbor Pkwy
Suite a
Fleming Island, FL 32003-4802

Phone

(904) 264-0004

Fax

(904) 264-0009

NPI assigned

Sep 13, 2013

Organization subpart

No

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

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1558796151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "address_2": "SUITE 907",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252",
            "telephone_number": "904-309-8680",
            "fax_number": "904-345-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1677 EAGLE HARBOR PKWY",
            "address_2": "SUITE A",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034802",
            "telephone_number": "904-264-0004",
            "fax_number": "904-264-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "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": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "94980",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.