RADIATION ONCOLOGY ST MARY PLACE LLC (NPI# 1225258809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225258809 |
| Entity Type | Organization |
| Organization Name | RADIATION ONCOLOGY ST MARY PLACE LLC |
| Practice Address |
One Saint Mary Place Cancer Treatment Center Shreveport LA 71101-4343 |
| Mailing Address |
Po Box 9600 Dept 09 042 Texarkana TX 75505 |
| Practice Telephone | 3186814126 |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2008-05-21 |
| Authorized Official Name | LANE ROSEN (MD OWNER) |
| Authorized Official Telephone | 3182221149 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
022404 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
ONE SAINT MARY PLACE CANCER TREATMENT CENTER |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285632745 | Peyman Roohani | Internal Medicine | One Saint Mary Place, Shreveport, LA 71101-0000 | 2005-07-08 |
| 1215170527 | Heith Edward Pumphrey | Nurse Practitioner | One Saint Mary Place, Shreveport, LA 71101-0000 | 2009-04-16 |
| 1700086063 | Stephen Royce Maxwell | Internal Medicine | One Saint Mary Place, Shreveport, LA 71101-0000 | 2007-07-24 |
| 1558469734 | Keith Eliot Strain | Pediatrics | One Saint Mary Place, Shreveport, LA 71101-4343 | 2006-09-20 |
| 1710909163 | Kevin Neal Boykin | Surgery | One Saint Mary Place, Shreveport, LA 71101-4343 | 2006-07-24 |
| 1760461875 | Kelly Morgan Carlisle | Internal Medicine | One Saint Mary Place, Shreveport, LA 71101-0000 | 2006-01-17 |
| 1689672032 | Mark Frederick Brown | Surgery | One Saint Mary Place, Shreveport, LA 71101-4343 | 2005-07-11 |
| 1487652970 | Thomas Steen Trawick Jr. | Internal Medicine | One Saint Mary Place, Shreveport, LA 71101-0000 | 2005-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669564258 | Radiation Oncology Services Apmc | Radiology | 2600 Kings Hwy., Shreveport, LA 71103 | 2006-09-29 |
| 1265439863 | Michael Leonard Durci | Radiology | 2600 Kings Hwy, Willis Knighton Cancer Center, Shreveport, LA 71103-3950 | 2005-06-28 |
| 1922478304 | Wk Radiation Oncology Services | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2015-09-29 |
| 1659767127 | Sergio Jaramillo | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2015-04-11 |
| 1457615395 | Chiachien Jake Wang | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2012-06-26 |
| 1093006603 | Daniella Phuong-di Dang | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2011-04-29 |
| 1770809238 | Promas LLC | Radiology | 1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105 | 2010-04-08 |
| 1548487804 | Radiation Oncology Associates A Medical Corporation | Radiology | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2007-04-19 |
| 1578576526 | Beng-hoey Jo | Radiology | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2006-08-14 |
| 1215943642 | Sanford Rory Katz | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2006-07-31 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.