Anna K. Fariss, MD, LLC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

11309R Issued in LA

Legal business name

ANNA K. FARISS, MD, LLC

Practice address

150 E Ponce de Leon
Avenue 120
Decatur, GA 30030-2543

Phone

(504) 650-7605

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Anna K. Fariss, MDNPI 1982713913

Title

President

Phone

(504) 650-7605

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anna K. Fariss, MD

  • Radiation Oncology Physician
  • Lebanon, NH
  • NPI 1982713913
  NPD Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841384518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E PONCE DE LEON",
            "address_2": "AVENUE 120",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302543",
            "telephone_number": "504-650-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E PONCE DE LEON",
            "address_2": "AVENUE 120",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302543",
            "telephone_number": "504-650-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNA K. FARISS, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FARISS",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-650-7605",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "LA",
            "license": "11309R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1670821",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Radiation Oncology Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Radiation Oncology Physician in Georgia

• 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.