NPIMap

Organization Active NPI

Integrated Community Oncology Network LLC

Doing business as Cancer Specialists of North Florida

  • Hematology & Oncology Physician
  • Jacksonville, FL
National Provider Identifier
1851388128
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC
Doing business as
Cancer Specialists of North Florida
Practice address
2 Shircliff Way
Suite 800
Jacksonville, FL 32204-4732
Phone
(904) 388-2619
Fax
(904) 388-0240
NPI assigned
Oct 3, 2005
Last updated
May 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Authorized official

Name
Mr. Robert J Phelan
Title
Ceo
Phone
(904) 363-2113

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Hematology & Oncology Physician 207RH0003X FL Primary

Addresses

Primary practice location

2 Shircliff Way
Suite 800
Jacksonville, FL 32204-4732

Mailing address

9143 Philips Hwy
Ste 560
Jacksonville, FL 32256-1348
Phone (904) 363-2113

Other identifiers 2

IdentifierTypeStateIssuer
94890OtherFLBCBS
273427320MedicaidFL

Other names 1

  • Cancer Specialists of North Florida Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1851388128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9143 PHILIPS HWY",
            "address_2": "STE 560",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322561348",
            "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": "2 SHIRCLIFF WAY",
            "address_2": "SUITE 800",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044732",
            "telephone_number": "904-388-2619",
            "fax_number": "904-388-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "PHELAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-363-2113",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "94890",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273427320",
            "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 May 24, 2012; 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.