Southeastern Oncology Associates, PC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

SOUTHEASTERN ONCOLOGY ASSOCIATES, PC

Practice address

2018 Brookwood Medical Ctr Dr
Cancer Center
Birmingham, AL 35209-6898

Phone

(205) 877-2339

Fax

(205) 877-1821

NPI assigned

Jun 13, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judy A Campodonico

Title

Director of Operations

Phone

(205) 897-8294

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Practitioners 4

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.

• Roland F Dumas Jr., MD

  • Radiation Oncology Physician
  • Birmingham, AL
  • NPI 1639111446
  Medicare reassignment NPD
• Virginia H Nix, CRNP

  • Nurse Practitioner
  • Tuscaloosa, AL
  • NPI 1033341201
  Medicare reassignment NPD
• Tyler Lane Till, CRNP

  • Family Nurse Practitioner
  • Birmingham, AL
  • NPI 1689072191
  Medicare reassignment NPD
• Sandra Tincher, MD

  • Radiation Oncology Physician
  • Birmingham, AL
  • NPI 1972546232
  Medicare reassignment NPD

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578506325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660928",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352660928",
            "telephone_number": "205-879-8294",
            "fax_number": "205-879-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 BROOKWOOD MEDICAL CTR DR",
            "address_2": "CANCER CENTER",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096898",
            "telephone_number": "205-877-2339",
            "fax_number": "205-877-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN ONCOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CAMPODONICO",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "205-897-8294"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeastern Brace, LLC (Alabama Pain Physicians)
• Southeastern Bracing LLC
• Southeastern Dermatology Centers
• Southeastern Diagnostic & Rehabilitation, LLC
• Southeastern Hospital Medicine LLC
• Southern Anesthesia Services
• Southern Belle Group Inc
• Southern Dental Birmingham, LLC
• Southern Dental Sleep Specialists LLC
• Southern ENT & Sinus Center, P.C.

• Radiation Oncology Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Radiation Oncology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.