Mt Vernon Radiation Therapy Center

Primary specialty

Radiation Oncology Clinic/CenterTaxonomy code 261QX0203X

Legal business name

MT VERNON RADIATION THERAPY CENTER

Practice address

4117 Veterans Memorial Dr
Mount Vernon, IL 62864-6262

Phone

(618) 241-1827

NPI assigned

Nov 28, 2006

Last updated

Jul 21, 2022By 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

Mr. Richard Huntington

Title

Vice President Business Development

Phone

(618) 241-2204

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Good Samaritan Regional Health Center

  dba SSM Health Good Samaritan Hospital - Mt. Vernon

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1487758801

  Member Of

  NPD member

Locations

Practitioners 6

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.

• William H Dunn, MD

  • Radiation Oncology Physician
  • Peoria, IL
  • NPI 1669447504
  Medicare reassignment Care Compare group NPD
• Graeme Donald Fisher, M.D.

  • Therapeutic Radiology Physician
  • Mount Vernon, IL
  • NPI 1659362929
  Medicare reassignment Care Compare group NPD
• Roby Adhinayak Lal, DO

  • Radiation Oncology Physician
  • Peoria, IL
  • NPI 1811983489
  Medicare reassignment Care Compare group NPD
• Kenneth Klein, MD

  • Radiation Oncology Physician
  • Eau Claire, WI
  • NPI 1891736963

  IL

  Medicare reassignment Care Compare group NPD
• Khadijeh S. Zarkoob, M.D.

  • Therapeutic Radiology Physician
  • Lewiston, ID
  • NPI 1295705630

  IL

  Medicare reassignment Care Compare group NPD
• Veena Kunigal, MD

  • Radiation Oncology Physician
  • Saint Louis, MO
  • NPI 1669443248

  IL

  Medicare reassignment NPD

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1952477028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 504229",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631500001",
            "telephone_number": "618-241-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 VETERANS MEMORIAL DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646262",
            "telephone_number": "618-241-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT VERNON RADIATION THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HUNTINGTON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VICE PRESIDENT BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "618-241-2204",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QX0203X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology, Radiation",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4132037",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "276923",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mt Vernon Community Pharmacy Inc (The Medicine Shoppe)
• Mt Vernon Community Pharmacy Inc (The Medicine Shoppe)
• Mt Vernon Cty SCH Dist 80
• Mt Vernon Family Practice PC
• Mt Vernon Neurology, S.C.
• Mt Vernon Spine and Disc Center, LLC
• Mt Vernon TWP HS Dist 201
• Mt. Vernon Chiropractic Clinic, PLLC
• Mt. Vernon Eye Clinic, PLLC (Mt. Vernon Eye Clinic)
• Mt. Vernon OB-GYN LLC

• Radiation Oncology Clinic/Center in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Radiation Oncology Clinic/Center in Illinois

• 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.