SATILLA CANCER TREATMENT CENTERS, LLC (NPI# 1336477934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336477934 |
| Entity Type | Organization |
| Organization Name | SATILLA CANCER TREATMENT CENTERS, LLC |
| Practice Address |
2406 Bellevue Avenue #7 Dublin GA 31021-0000 |
| Practice Telephone | 4782722255 |
| Practice Fax Number | 4782759134 |
| Mailing Telephone | 4782722255 |
| Mailing Fax Number | 4782759134 |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2012-10-02 |
| Authorized Official Name | JACQUELINE LILLICOTCH (CREDENTIALING OFFICER) |
| Authorized Official Telephone | 4782722255 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447467717 | Satilla Cancer Treatment Centers, LLC | Specialist | 1451 Church St, Waycross, GA 31501-3531 | 2007-05-17 |
| 1700026606 | Satilla Cancer Treatment Centers, LLC | Internal Medicine | 1451 Church St, Waycross, GA 31501-3531 | 2009-03-05 |
| 1104033463 | Satilla Cancer Treatment Centers, LLC | Specialist | 2406 Bellevue Rd, #7, Dublin, GA 31021-2842 | 2007-05-17 |
| Street Address |
2406 BELLEVUE AVENUE #7 |
| City | DUBLIN |
| State | GA |
| Zip Code | 31021-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497213748 | Ronald E. Johnson | Peer Specialist | Carl Vinson Va Medical Center, 1826 Veterans Blvd., Dublin, GA 31021 | 2019-03-06 |
| 1902384811 | Nieka Jackson | Pharmacist | 75 Woodlawn Dr, Apt. C-1, Dublin, GA 31021 | 2018-08-02 |
| 1407341522 | Empower Psychiatry & Weight Loss, LLC | Nurse Practitioner | 112 Rowe St Ste B, Dublin, GA 31021 | 2018-06-30 |
| 1619462207 | Kara Emily Frost | Speech-Language Pathologist | 1406 Bellevue Rd, Dublin, GA 31021 | 2018-06-26 |
| 1376035410 | Owens Speech Services, LLC | Speech-Language Pathologist | 401 Barfield Court, Dublin, GA 31021 | 2018-06-05 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1376991000 | Eatonton Facility Development Company, LLC | Hospice, Inpatient | 155 Greensboro Rd, Eatonton, GA 31021 | 2016-06-03 |
| 1801261177 | Jones Community Health Center, LLC | Clinic/Center | 115 Shadow Pond, Dublin, GA 31021 | 2015-12-11 |
| 1508237561 | Cancer Center of Middle Georgia | Specialist | 26 Erin Office Park, Dublin, GA 31021 | 2015-10-15 |
| 1922477249 | Mickey Jackson | Non-emergency Medical Transport (VAN) | 610 John Robinson Tl., Dublin, GA 31021 | 2015-09-16 |
| Find all providers in zip 31021 | ||||
| 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 |
|---|---|---|---|---|
| 1922071844 | Carl Craig Van Wey | Radiology | 6380 Clark Ave, Dublin, CA 94568-3036 | 2006-02-10 |
| 1275755621 | Gautam Prasad | Radiology | 6380 Clark Ave, Dublin, CA 94568-3036 | 2007-05-03 |
| 1215063094 | Anand Parthasarathy | Radiology | 3100 Dublin Blvd, Dublin, CA 94568-4363 | 2007-02-26 |
| 1700859352 | Michael Richard Forrest | Radiology | 6380 Clark Ave, Dublin, CA 94568-3036 | 2006-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1962910679 | American Professional Associates LLC | Radiology | 33 Upper Riverdale Rd Sw Ste 105, Riverdale, GA 30274-2642 | 2018-01-16 |
| 1003324187 | American Professional Associates LLC | Radiology | 1136 Cleveland Ave Ste 119, East Point, GA 30344-3618 | 2018-01-11 |
| 1316387137 | Rakendu Prakash Shukla | Radiology | 148 Bill Carruth Pkwy Ste Ll30, Hiram, GA 30141-3768 | 2013-06-25 |
| 1023301082 | Jolinta Lin | Radiology | The Emory Clinic Dept of Radiation Oncology, 1365 Clifton Road, Ne, Atlanta, GA 30322-0001 | 2011-05-25 |
| 1679739825 | Charles Reginald Woods IIi | Radiology | 275 Professional Ct, Suite B, Riverdale, GA 30274-2531 | 2008-08-06 |
| 1003086216 | Coastal Radiation Oncology Assoc. | Radiology | 2500 Starling St Ste 107, Brunswick, GA 31520-4266 | 2008-03-04 |
| 1275710899 | Shannon Tucker Kahn | Radiology | 639 Kimberly Ln Ne, Atlanta, GA 30306-2224 | 2008-01-25 |
| 1295924801 | Brian Wise Weaver | Radiology | 1355 Heatherland Dr Sw, Atlanta, GA 30331-7460 | 2007-10-19 |
| 1225245798 | John W Devine, Md, PC | Radiology | 209 Pendleton Dr, Valdosta, GA 31602-1729 | 2007-05-16 |
| Find all providers with the same taxonomy | ||||
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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.