NPIMap

Organization Active NPI

Northwest Baltimore Radiation Therapy Regional Center, LLC

Doing business as Lifebridge Health Radiation Oncology Center at Owing Mills

  • Radiation Oncology Physician
  • Owings Mills, MD
National Provider Identifier
1639145279
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
NORTHWEST BALTIMORE RADIATION THERAPY REGIONAL CENTER, LLC
Doing business as
Lifebridge Health Radiation Oncology Center at Owing Mills
Practice address
25 Crossroads Dr
Suite110
Owings Mills, MD 21117-5421
Phone
(410) 998-9993
Fax
(410) 998-4242
NPI assigned
Feb 24, 2006
Last updated
Jan 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Authorized official

Name
David N.T. Watson
Title
Cfo
Phone
(239) 931-7342

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X NU Primary

Addresses

Primary practice location

25 Crossroads Dr
Suite110
Owings Mills, MD 21117-5421

Mailing address

2234 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other identifiers 1

IdentifierTypeStateIssuer
CK7262OtherMDRAILROAD MEDICARE

Other names 1

  • Lifebridge Health Radiation Oncology Center at Owing Mills Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1140739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1639145279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DR",
            "address_2": "SUITE110",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175421",
            "telephone_number": "410-998-9993",
            "fax_number": "410-998-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST BALTIMORE RADIATION THERAPY REGIONAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-24",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "N.T.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "239-931-7342"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK7262",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifebridge Health Radiation Oncology Center at Owing Mills",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.