NPIMap

Organization Active NPI

Charleston Radiation Therapy Consultants PLLC

  • Radiation Oncology Physician
  • Charleston, WV
National Provider Identifier
1942208145
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
CHARLESTON RADIATION THERAPY CONSULTANTS PLLC
Practice address
3415 Maccorkle Ave SE
Charleston, WV 25304
Phone
(304) 388-1790
Fax
(304) 388-1768
NPI assigned
Jul 12, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Rebecca Horton
Title
Provider Enrollment Coordinator
Phone
(800) 451-4959

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 001 WV
Radiation Oncology Physician 2085R0001X NU Primary

Addresses

Primary practice location

3415 Maccorkle Ave SE
Charleston, WV 25304

Mailing address

PO Box 896158
Charlotte, NC 28289-6158
Phone (800) 451-4959

Other identifiers 1

IdentifierTypeStateIssuer
0007557000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000446 WV Part B Supplier - Clinic/Group Practice 4688579428 Receives reassigned benefits from 10 practitioners
Practice locations: Charleston, WV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1942208145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896158",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282896158",
            "telephone_number": "800-451-4959",
            "fax_number": "602-773-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-388-1790",
            "fax_number": "304-388-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON RADIATION THERAPY CONSULTANTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2022-07-21",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "HORTON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "800-451-4959"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "001",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007557000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.