The Breast Care Team , PC

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

053464 Issued in GA

Legal business name

THE BREAST CARE TEAM , PC

Practice address

130 Riverstone Ter
Suite 101
Canton, GA 30114-1702

Phone

(770) 704-6977

Fax

(770) 704-6169

NPI assigned

Oct 15, 2007

Last updated

Dec 19, 2007By 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

Dr. Anita T Johnson

Title

Physician/Owner

Phone

(770) 704-6977

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1942498050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 RIVERSTONE TER",
            "address_2": "SUITE 101",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301141702",
            "telephone_number": "770-704-6977",
            "fax_number": "770-704-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 RIVERSTONE TER",
            "address_2": "SUITE 101",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301141702",
            "telephone_number": "770-704-6977",
            "fax_number": "770-704-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BREAST CARE TEAM , PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "770-704-6977",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": "GA",
            "license": "053464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Oncology Physician in Canton, GA
• Providers in Canton, GA by specialty
• Surgical Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.

Verify at the official NPI Registry.