NPIMap

Organization Active NPI

Peachtree Radiation Oncology Services PC

  • Radiation Oncology Physician
  • Atlanta, GA
National Provider Identifier
1750496527
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
PEACHTREE RADIATION ONCOLOGY SERVICES PC
Practice address
1968 Peachtree Rd NW
Dept of Radiation Oncology
Atlanta, GA 30309-1281
Phone
(404) 605-3319
Fax
(770) 916-4434
NPI assigned
Aug 20, 2006
Last updated
Jun 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Authorized official

Name
Adam Wayne Nowlan, MD, MPHNPI 1710913165
Title
President
Phone
(404) 605-3319

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X Primary

Addresses

Primary practice location

1968 Peachtree Rd NW
Dept of Radiation Oncology
Atlanta, GA 30309-1281

Mailing address

PO Box 102543
Atlanta, GA 30368-2543
Phone (404) 605-3319

Other names 1

  • Radiation Oncology PC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040406000249 GA Part B Supplier - Clinic/Group Practice 1850384801 Receives reassigned benefits from 8 practitioners
Practice locations: Atlanta, GA; Cartersville, GA

National Provider Directory

National Provider Directory

Locations

1968 Peachtree Rd NW
#D
Atlanta, GA 30309
Phone (404) 605-3319

3200 Downwood Cir NW
Ste 150
Atlanta, GA 30327

NW
1968 Peachtree Rd
Atlanta, GA 30309
Phone (404) 605-3319

1255 Highway 54 W
Bldg 1267
Fayetteville, GA 30214
Phone (770) 719-5850

1267 Highway 54 W
Ste 1500
Fayetteville, GA 30214
Phone (770) 719-5850

Practitioners & affiliated clinicians

Practitioners 10

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1750496527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102543",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682543",
            "telephone_number": "404-605-3319",
            "fax_number": "770-916-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE RD NW",
            "address_2": "DEPT OF RADIATION ONCOLOGY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091281",
            "telephone_number": "404-605-3319",
            "fax_number": "770-916-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE RADIATION ONCOLOGY SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "NOWLAN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-605-3319",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiation Oncology PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Radiation Oncology PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.