Integrated Community Oncology Network LLC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC

Doing business as

Florida Radiation Oncology Group

Practice address

300 Health Park Blvd
Suite 1008
St Augustine, FL 32086-3707

Phone

(904) 824-5189

Fax

(904) 824-9109

NPI assigned

Jul 12, 2006

Last updated

Jan 21, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shyam B Paryani, MD

Title

Director

Phone

(904) 309-8680

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Florida Radiation Oncology Group Doing business as

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1861427155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19675",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322459675",
            "telephone_number": "904-309-8680",
            "fax_number": "904-345-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK BLVD",
            "address_2": "SUITE 1008",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863707",
            "telephone_number": "904-824-5189",
            "fax_number": "904-824-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "PARYANI",
        "authorized_official_first_name": "SHYAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-309-8680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "94890",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273427311",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DC6938",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Radiation Oncology Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Radiation Oncology Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Radiation Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.