Organization Active NPI

Ashland Radiation Oncology, PSC

  • Radiation Oncology Physician
  • Ashland, KY
National Provider Identifier
1972648285
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
ASHLAND RADIATION ONCOLOGY, PSC
Practice address
706 23Rd St
Tri-State Regional Cancer Center
Ashland, KY 41101-2832
Phone
(606) 329-0060
Fax
(606) 325-9366
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Authorized official

Name
Mrs. Kelly M Lopez
Title
Business Manager
Phone
(606) 329-0060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

706 23Rd St
Tri-State Regional Cancer Center
Ashland, KY 41101-2832

Mailing address

706 23Rd St
Tri-State Regional Cancer Center
Ashland, KY 41101-2832
Phone (606) 329-0060

Other identifiers 2

IdentifierTypeStateIssuer
3810004701MedicaidWV
65919201MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040805000121 KY Part B Supplier - Clinic/Group Practice 3072584762 Receives reassigned benefits from 2 practitioners
Practice locations: Ashland, KY

National Provider Directory

National Provider Directory

Locations

706 23rd St
Ashland, KY 41101
Phone (606) 329-0060

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379548800000",
    "number": "1972648285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 23RD ST",
            "address_2": "TRI-STATE REGIONAL CANCER CENTER",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012832",
            "telephone_number": "606-329-0060",
            "fax_number": "606-325-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 23RD ST",
            "address_2": "TRI-STATE REGIONAL CANCER CENTER",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012832",
            "telephone_number": "606-329-0060",
            "fax_number": "606-325-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLAND RADIATION ONCOLOGY, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2013-09-19",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "606-329-0060",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004701",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65919201",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.