NPIMap

Organization Active NPI

Radiation Therapy Associates of Western North Carolina PA

Doing business as Pulmonary Specialists of Western North Carolina

  • Pulmonary Disease Physician
  • Clyde, NC
National Provider Identifier
1720419955
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
RADIATION THERAPY ASSOCIATES OF WESTERN NORTH CAROLINA PA
Doing business as
Pulmonary Specialists of Western North Carolina
Practice address
600 Hospital Dr
Suite 4
Clyde, NC 28721-8046
Phone
(828) 456-7226
Fax
(828) 456-7274
NPI assigned
Dec 13, 2013
Reactivated
Jul 19, 2019
Last updated
Jul 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Authorized official

Name
Timothy D. Shafman, MDNPI 1366424533
Title
President
Phone
(401) 456-2690

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

600 Hospital Dr
Suite 4
Clyde, NC 28721-8046

Mailing address

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

Other names 1

  • Pulmonary Specialists of Western North Carolina Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080226000385 NC Part B Supplier - Clinic/Group Practice 0042246050 Receives reassigned benefits from 22 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Weaverville, NC; Marion, NC; Brevard, NC; Hendersonville, NC; Goldsboro, NC; Clyde, NC; Forest City, NC; Asheville, NC…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1386892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1720419955",
    "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": "600 HOSPITAL DR",
            "address_2": "SUITE 4",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287218046",
            "telephone_number": "828-456-7226",
            "fax_number": "828-456-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIATION THERAPY ASSOCIATES OF WESTERN NORTH CAROLINA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-13",
        "last_updated": "2019-07-19",
        "deactivation_date": "2019-07-11",
        "reactivation_date": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "SHAFMAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-456-2690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pulmonary Specialists of Western North Carolina",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pulmonary Specialists of Western North Carolina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clyde, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.