Central Nebraska Radiation Oncology, PC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

18773 Issued in NE

Legal business name

CENTRAL NEBRASKA RADIATION ONCOLOGY, PC

Practice address

2116 W Faidley Ave
Department of Radiation Therapy
Grand Island, NE 68803-4645

Phone

(308) 398-5450

Fax

(308) 398-5351

NPI assigned

Apr 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark Edwin Bolton, M.D.

Title

President

Phone

(308) 398-5450

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700909488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56",
            "city": "SAINT LIBORY",
            "state": "NE",
            "postal_code": "688720056",
            "telephone_number": "308-687-6288",
            "fax_number": "308-687-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 W FAIDLEY AVE",
            "address_2": "DEPARTMENT OF RADIATION THERAPY",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034645",
            "telephone_number": "308-398-5450",
            "fax_number": "308-398-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL NEBRASKA RADIATION ONCOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "308-398-5450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "NE",
            "license": "18773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anahi Ceballos Rosales
• Cedars at Broadwell LLC
• Central District Health Department
• Central Nebraska Home Care Services
• Central Nebraska Orthopedics & Sports Medicine, P.C.
• Kathryn Cerny
• Claudette Lucille Cersei, RN
• Lizeth Cervantes
• Loyda E Cervantes
• Niesa Cervantes

• Radiation Oncology Physician in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Radiation Oncology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.