NPIMap

Organization Active NPI

Radiation Therapy Associates of Western North Carolina PA

Doing business as Blue Mountain Surgery

  • Surgery Physician
  • Asheville, NC
National Provider Identifier
1992049118
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
RADIATION THERAPY ASSOCIATES OF WESTERN NORTH CAROLINA PA
Doing business as
Blue Mountain Surgery
Practice address
1 Hospital Dr
Suite 102
Asheville, NC 28801-4550
Phone
(828) 251-2523
Fax
(828) 251-2527
NPI assigned
Nov 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Authorized official

Name
Timothy D. Shafman, MDNPI 1366424533
Title
President
Phone
(401) 456-2690

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1 Hospital Dr
Suite 102
Asheville, NC 28801-4550

Mailing address

2234 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other names 1

  • Blue Mountain Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080226000385 NC Part B Supplier - Clinic/Group Practice 0042246050 Receives reassigned benefits from 22 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Weaverville, NC; Marion, NC; Brevard, NC; Hendersonville, NC; Goldsboro, NC; Clyde, NC; Forest City, NC; Asheville, NC…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1992049118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "SUITE 102",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014550",
            "telephone_number": "828-251-2523",
            "fax_number": "828-251-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIATION THERAPY ASSOCIATES OF WESTERN NORTH CAROLINA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "SHAFMAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-456-2690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Mountain Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Mountain Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.