NPIMap

Individual provider Active NPI

Vic Liengswangwong, M.D.

  • Radiation Oncology Physician
  • Florence, AL
National Provider Identifier
1851360796
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
63950-20 Issued in WI
Practice address
1751 Veterans Dr
Florence, AL 35630-4929
Phone
(256) 629-4800
Fax
(256) 629-4899
NPI assigned
Mar 14, 2006
Last updated
Mar 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 34883 MN
Radiation Oncology Physician 2085R0001X 63950-20 WI Primary

Addresses

Primary practice location

1751 Veterans Dr
Florence, AL 35630-4929

Mailing address

1701 Veterans Dr Ste 190
Florence, AL 35630-4928
Phone (256) 629-4800

Other identifiers 9

IdentifierTypeStateIssuer
1027665OtherMNPREFERRED ONE
275404MedicaidAL
2400058OtherMNMEDICA
1296554OtherMNAMERICA'S PPO
095514100MedicaidMN
34075000MedicaidWI
HP32879OtherMNHEALTHPARTNERS
151702OtherMNUCARE MN
69B76LIOtherMNBLUE CROSS BLUE SHIELD MN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI, AL3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20051121000568 MN Practitioner - Radiation Oncology 3870512759 Reassigns benefits to 1 organization
I20160916000903 WI Practitioner - Radiation Oncology 3870512759 Reassigns benefits to 2 organizations
I20211210000059 AL Practitioner - Radiation Oncology 3870512759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Range Regional Health ServicesGroup PAC ID 8022920024, 349 clinicians

Practice addresses (Care Compare)

750 E 34TH St
Hibbing, MN 55746-4600
Phone (218) 262-4881

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
63950-20WIMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RCHP - Florence LLC CurrentSince Jan 30, 2022 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Jul 30, 2018 Accepting new patients
Ecm Health Group LLC Radiation Oncology CurrentSince Nov 1, 2021 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. Radiation Oncology CurrentSince Jul 30, 2018 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. Radiation Oncology CurrentSince Jul 30, 2018 Accepting new patients
Range Regional Health Services CurrentSince Sep 1, 2024 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Jul 30, 2018 Accepting new patients
RCHP - Florence LLC CurrentSince Jan 30, 2022 Accepting new patients
Range Regional Health Services CurrentSince Sep 1, 2024 Accepting new patients
University of Alabama Health Services Foundation, PC. Past Accepting new patients
Range Regional Health Services Past Accepting new patients
Dean Health Systems, Inc. Past Accepting new patients
Minnesota Oncology Hematology, PA Radiation Oncology Past Accepting new patients
Minnesota Oncology Hematology, PA Radiation Oncology PastSince Jan 12, 2020 Accepting new patients

Locations

1701 Veterans Dr
Florence, AL 35630
Phone (256) 629-1900

1701 Veterans Dr
Ste 190
Florence, AL 35630

1751 Veterans Dr
Florence, AL 35630
Phone (256) 629-4800

541 W College St
Ste 3300
Florence, AL 35630
Phone (256) 766-6026

201 Avalon Ave
Muscle Shoals, AL 35661
Phone (256) 386-1600

29980 Network Pl
Chicago, IL 60673

1814 14th Ave E
Hibbing, MN 55746
Phone (218) 262-3441

3605 Mayfair Ave
Hibbing, MN 55746
Phone (218) 262-3441

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

Interoperability endpoints

  • Direct secure messaging: vliengswangwong191901@fairview.direct-ci.com

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1851360796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 VETERANS DR STE 190",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356304928",
            "telephone_number": "256-629-4800",
            "fax_number": "256-629-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 VETERANS DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356304929",
            "telephone_number": "256-629-4800",
            "fax_number": "256-629-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIENGSWANGWONG",
        "first_name": "VIC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MN",
            "license": "34883",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WI",
            "license": "63950-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1027665",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275404",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2400058",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "1296554",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095514100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34075000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP32879",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MN",
            "identifier": "151702",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "69B76LI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.