NPIMap

Organization Active NPI

Henry Radiation Oncology Center, LLC

  • Radiation Oncology Physician
  • Stockbridge, GA
National Provider Identifier
1689906505
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
HENRY RADIATION ONCOLOGY CENTER, LLC
Practice address
960 Hospital Dr
Stockbridge, GA 30281-7345
Phone
(770) 907-0554
Fax
(770) 907-9048
NPI assigned
Feb 3, 2010
Last updated
Feb 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Authorized official

Name
Nelda H Champagne
Title
Billing Supervisor
Phone
(770) 907-0554

Specialties & licenses 1

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

Addresses

Primary practice location

960 Hospital Dr
Stockbridge, GA 30281-7345

Mailing address

960 Hospital Dr
Stockbridge, GA 30281-7345

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

960 Hospital Dr
Stockbridge, GA 30281
Phone (770) 907-0554

Practitioners & affiliated clinicians

Practitioners 12

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": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1689906505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 HOSPITAL DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 HOSPITAL DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817345",
            "telephone_number": "770-907-0554",
            "fax_number": "770-907-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY RADIATION ONCOLOGY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "CHAMPAGNE",
        "authorized_official_first_name": "NELDA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "770-907-0554"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.