Integrated Community Oncology Network LLC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC

Doing business as

Cancer Specialists of North Florida

Practice address

5742 Booth Rd
Suite a
Jacksonville, FL 32207-5982

Phone

(904) 739-7779

Fax

(904) 739-7771

NPI assigned

Oct 3, 2005

Last updated

May 24, 2012By 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

Mr. Robert Phelan

Title

Ceo

Phone

(904) 363-2113

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Cancer Specialists of North Florida Doing business as

Locations

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1669469938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9143 PHILIPS HWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322561348",
            "telephone_number": "904-363-2113",
            "fax_number": "904-538-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5742 BOOTH RD",
            "address_2": "SUITE A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075982",
            "telephone_number": "904-739-7779",
            "fax_number": "904-739-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "PHELAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-363-2113",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273427315",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "94870",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cancer Specialists of North Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Integrated Community Oncology Network LLC (Florida Radiation Oncology Group)
• Integrated Community Oncology Network LLC (McIver Urological Clinic)
• Integrated Community Oncology Network LLC (Florida Radiation Oncology Group)
• Integrated Community Oncology Network LLC (Kasraeian Urology Divison of ICON)
• Integrated Community Oncology Network LLC (Cancer Specialist of North Florida)
• Integrated Community Oncology Network LLC (Cancer Specialists of North Florida)
• Integrated Community Oncology Network LLC (Florida Radiation Oncology Group)
• Integrated Community Oncology Network LLC (Cancer Specialists of North Florida)
• Integrated Community Oncology Network LLC (Cancer Specialists of North Florida)
• Integrated Community Oncology Network LLC (Cancer Specialists of North Florida)

• Hematology & Oncology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Hematology & Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.