Organization Active NPI

Cancer Specialists, LLC

  • Hematology & Oncology Physician
  • St Augustine, FL
National Provider Identifier
1699348268
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
CANCER SPECIALISTS, LLC
Practice address
121 Whitehall Drive
St Augustine, FL 32086-5266
Phone
(904) 825-4500
Fax
(904) 825-3672
NPI assigned
Jul 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Authorized official

Name
Robert J Phelan
Title
Ceo
Phone
(904) 363-7442

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X Primary
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X

Addresses

Primary practice location

121 Whitehall Drive
St Augustine, FL 32086-5266

Mailing address

7751 Belfort Pkwy Ste 350
Jacksonville, FL 32256-6951
Phone (904) 363-2113

Other identifiers 1

IdentifierTypeStateIssuer
GM089AOtherFLMEDICARE

Other names 1

  • Cancer Specialists of North Florida Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0978019Cancer Specialists LLC121 Whitehall Drive, Saint Augustine, FL 32086ComplianceNov 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Cancer Specialists LLC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

121 Whitehall Dr
St Augustine, FL 32086
Phone (904) 519-2738

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1699348268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7751 BELFORT PKWY STE 350",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566951",
            "telephone_number": "904-363-2113",
            "fax_number": "904-363-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WHITEHALL DRIVE",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865266",
            "telephone_number": "904-825-4500",
            "fax_number": "904-825-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-21",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "PHELAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-363-7442"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GM089A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cancer Specialists of North Florida",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cancer Specialists of North Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.