Active NPI
Cancer Specialists LLC
- Hematology & Oncology Physician
- Jacksonville, FL
National Provider Identifier
1801148473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- Legal business name
- CANCER SPECIALISTS LLC
- Practice address
- 5742 Booth Rd
Suite a
Jacksonville, FL 32207-5982 - Phone
- (904) 739-7779
- Fax
- (904) 739-7771
- NPI assigned
- Oct 8, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert J Phelan
- Title
- Credentialing
- Phone
- (904) 363-2113
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | FL | Primary | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | FL |
Addresses
Primary practice location
5742 Booth Rd
Suite a
Jacksonville, FL 32207-5982
Mailing address
7015 Ac Skinner Parkway
Suite 1
Jacksonville, FL 32256
Phone (904) 363-2113
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006337801 | Medicaid | FL |
Other names 1
- CANCER SPECIALISTS OF NORTH FLORIDA
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349654400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1625529600000",
"number": "1801148473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7015 AC SKINNER PARKWAY",
"address_2": "SUITE 1",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32256",
"telephone_number": "904-363-2113",
"fax_number": "904-538-3672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5742 BOOTH RD",
"address_2": "SUITE A",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322075982",
"telephone_number": "904-739-7779",
"fax_number": "904-739-7771"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CANCER SPECIALISTS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-10-08",
"last_updated": "2021-07-06",
"certification_date": "2021-07-06",
"status": "A",
"authorized_official_last_name": "PHELAN",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CREDENTIALING",
"authorized_official_telephone_number": "904-363-2113",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "FL",
"license": null,
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "FL",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006337801",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CANCER SPECIALISTS OF NORTH FLORIDA",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.