Therapeutic Radiation Oncology, PC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

THERAPEUTIC RADIATION ONCOLOGY, PC

Practice address

1255 Highway 54 W
Fayetteville, GA 30214-4526

Phone

(770) 719-5850

Fax

(770) 719-5849

NPI assigned

Jun 10, 2006

Organization subpart

No

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

Authorized official

Name

Nelda H Champagne

Title

Billing Manager

Phone

(770) 907-0554

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 10

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.

• John Harold Giesler, M.D.

  • Radiation Oncology Physician
  • Riverdale, GA
  • NPI 1649261926
  Medicare reassignment Care Compare group NPD
• Kim Vu Neisler, MD

  • Radiation Oncology Physician
  • Stockbridge, GA
  • NPI 1093760217
  Medicare reassignment Care Compare group NPD
• Geetha Shiva Rao, MD

  • Radiation Oncology Physician
  • Fayetteville, GA
  • NPI 1255370375
  Medicare reassignment Care Compare group NPD
• Diana Alma Santiago, MD

  • Radiation Oncology Physician
  • Newnan, GA
  • NPI 1073552196
  Medicare reassignment Care Compare group NPD
• David Lawson Shaw, MD

  • Radiation Oncology Physician
  • Austell, GA
  • NPI 1164461281
  Medicare reassignment Care Compare group NPD
• Sasha Hyatt Wahab, MD, MA

  • Radiation Oncology Physician
  • Stockbridge, GA
  • NPI 1053438762
  Medicare reassignment Care Compare group NPD
• Christopher John Williamson, MD

  • Radiation Oncology Physician
  • Stockbridge, GA
  • NPI 1326675208
  Medicare reassignment Care Compare group NPD
• Charles Reginald Woods III, M.D.

  • Radiation Oncology Physician
  • Riverdale, GA
  • NPI 1679739825
  Medicare reassignment Care Compare group NPD
• Radhika Sreeraman Kumar, M.D.

  • Radiation Oncology Physician
  • Santa Clara, CA
  • NPI 1265711394

  GA

  Medicare reassignment
• Shelley Machuta Fernandes, MD

  • Radiation Oncology Physician
  • Cumming, GA
  • NPI 1639153828
  NPD

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1629019534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 PROFESSIONAL CT",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742531",
            "telephone_number": "770-907-0554",
            "fax_number": "770-907-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144526",
            "telephone_number": "770-719-5850",
            "fax_number": "770-719-5849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "745 Poplar Rd",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302651618",
            "country_code": "US",
            "telephone_number": "770-400-4700",
            "fax_number": "770-400-4096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1133 Eagles Landing Pkwy",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302815085",
            "country_code": "US",
            "telephone_number": "678-251-1099",
            "fax_number": "678-604-1960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERAPEUTIC RADIATION ONCOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "CHAMPAGNE",
        "authorized_official_first_name": "NELDA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "770-907-0554"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300021609A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629019534",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Living Well Agency, LLC
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• The Progressive Counseling and Therapy Center, LLC
• The Pursuit Counseling LLC
• Therapy for Ladies
• Therapy Networks and Psychological Services
• Think Healthy, LLC
• Tanya Thomas Biles
• Thomas M. Brown, O.D.,P.C. (Visionary Eyecare)

• Radiation Oncology Physician in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Radiation Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.