Active NPI
Radiation Oncology Specialists
- Radiation Oncology Physician
- Chattanooga, TN
National Provider Identifier
1942490859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- Legal business name
- RADIATION ONCOLOGY SPECIALISTS
- Practice address
- 2525 Desales Ave
Suite 200
Chattanooga, TN 37404-1161 - Phone
- (423) 495-3748
- Fax
- (423) 495-5623
- NPI assigned
- Jul 26, 2007
- Last updated
- Jul 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eric R Ellis, MD
- Title
- Owner
- Phone
- (423) 495-3748
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | NU | Primary |
Addresses
Primary practice location
2525 Desales Ave
Suite 200
Chattanooga, TN 37404-1161
Mailing address
2525 Desales Ave
Suite 200
Chattanooga, TN 37404-1161
Phone (423) 495-3748
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3047075 | Medicaid | TN |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1185408000000",
"number": "1942490859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 DESALES AVE",
"address_2": "SUITE 200",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374041161",
"telephone_number": "423-495-3748",
"fax_number": "423-495-5623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 DESALES AVE",
"address_2": "SUITE 200",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374041161",
"telephone_number": "423-495-3748",
"fax_number": "423-495-5623"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RADIATION ONCOLOGY SPECIALISTS",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-26",
"last_updated": "2007-07-26",
"status": "A",
"authorized_official_last_name": "ELLIS",
"authorized_official_first_name": "ERIC",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "423-495-3748",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3047075",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.