INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC (NPI# 1457529786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457529786 |
| Entity Type | Organization |
| Organization Name | INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC |
| Other Organization Name | MCIVER UROLOGICAL CLINIC |
| Practice Address |
710 Lomax St Jacksonville FL 32204-4004 |
| Mailing Address |
9143 Philips Hwy Suite 560 Jacksonville FL 32256-1348 |
| Practice Telephone | 9043556583 |
| Practice Fax Number | 9043554922 |
| Mailing Telephone | 9043637453 |
| Mailing Fax Number | 9045383672 |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2009-03-19 |
| Authorized Official Name | ROBERT J PHELAN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9043632113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | DC6938 | 01 |
| Other Name | Type Code |
|---|---|
| McIver Urological Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023054921 | Integrated Community Oncology Network LLC | Internal Medicine | 1689 Eagle Harbor Pkwy, Suite C, Orange Park, FL 32003-4817 | 2006-06-21 |
| 1932196243 | Integrated Community Oncology Network LLC | Internal Medicine | 9143 Philips Hwy, Ste 560, Jacksonville, FL 32256-1348 | 2005-10-03 |
| 1730176017 | Integrated Community Oncology Network LLC | Durable Medical Equipment & Medical Supplies | 600 Zeagler Drive, Suite 1, Palatka, FL 32177 | 2005-10-03 |
| 1821085101 | Integrated Community Oncology Network LLC | Durable Medical Equipment & Medical Supplies | 2161 Kingsley Avenue, Suite 200, Orange Park, FL 32073 | 2005-10-03 |
| 1558796151 | Integrated Community Oncology Network LLC | Internal Medicine | 1677 Eagle Harbor Pkwy, Suite A, Fleming Island, FL 32003-4802 | 2013-09-13 |
| 1649574500 | Integrated Community Oncology Network LLC | Urology | 6269 Beach Blvd, Suite 2, Jacksonville, FL 32216-2768 | 2011-01-06 |
| 1720310733 | Integrated Community Oncology Network LLC | Urology | 1715 Village Way, Orange Park, FL 32073-5263 | 2010-02-02 |
| 1467683839 | Integrated Community Oncology Network LLC | Radiology | 425 S Parsons Ave, Suite 102, Brandon, FL 33511-5289 | 2009-08-04 |
| 1407096183 | Integrated Community Oncology Network LLC | Radiology | 710 Lomax St, Suite 1, Jacksonville, FL 32204-4004 | 2009-02-20 |
| 1225234404 | Integrated Community Oncology Network LLC | Radiology | 200 N Mangoustine Ave, Sanford, FL 32771-1017 | 2007-06-25 |
| Street Address |
710 LOMAX ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154396695 | Shannon Marie Cordes | Nurse Practitioner | 710 Lomax St, Jacksonville, FL 32204-4004 | 2006-02-20 |
| 1740741495 | Michael Wilson | Nurse Practitioner | 710 Lomax St, Jacksonville, FL 32204-4015 | 2019-03-26 |
| 1003254228 | Kyle Hollingsworth | Specialist/Technologist | 710 Lomax St, Jacksonville, FL 32204-4015 | 2013-06-10 |
| 1700129707 | Matthew Alan Nielsen | Urology | 710 Lomax St, Jacksonville, FL 32204 | 2013-03-28 |
| 1619221637 | Florida Physician Specialists LLC | Urology | 710 Lomax St, Jacksonville, FL 32204-4004 | 2012-10-29 |
| 1588917108 | Florida Physician Specialists LLC | Radiology | 710 Lomax St, Suite 1, Jacksonville, FL 32204-4004 | 2012-10-19 |
| 1114224961 | Tara A Romeu | Physician Assistant | 710 Lomax St, Jacksonville, FL 32204-4015 | 2011-02-14 |
| 1407096183 | Integrated Community Oncology Network LLC | Radiology | 710 Lomax St, Suite 1, Jacksonville, FL 32204-4004 | 2009-02-20 |
| 1770604548 | Sagar R. Shah | Urology | 710 Lomax St, Jacksonville, FL 32204-4004 | 2007-04-02 |
| 1548301336 | James Atherton Baldock | Urology | 710 Lomax St, Jacksonville, FL 32204-4004 | 2007-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053859041 | Soroush Bazargani | Urology | 653 W 8th St Lrc Bldg Fl 2, Jacksonville, FL 32216-6511 | 2017-02-09 |
| 1538534409 | Clinical Urology Associates, P.C. | Urology | 820 Pelham Rd S, Jacksonville, AL 36265-2736 | 2015-12-03 |
| 1356692065 | Onslow Ambulatory Services, Inc. | Urology | 52 Office Park Dr, Suite B, Jacksonville, NC 28546-3217 | 2012-09-21 |
| 1841586120 | Travis Christopher Allemang | Urology | 2080 Child St Dept 5000, Jacksonville, FL 32214 | 2011-06-24 |
| 1275597817 | Thomas L Wilson M D Ltd | Urology | 814 W State, Jacksonville, IL 62650 | 2006-04-12 |
| 1164484267 | Charles Stott Wilson | Urology | 814 West State, Jacksonville, IL 62650 | 2006-04-04 |
| 1912967860 | Fawaz M Ashouri | Urology | 2301 University Blvd W, Jacksonville, FL 32217 | 2006-03-24 |
| 1972578136 | Christopher Ramon Williams | Urology | 8708 Perimeter Park Blvd Ste 4, Jacksonville, FL 32216 | 2006-02-21 |
| 1659374320 | Ahmad Kasraeian | Urology | 6269 Beach Blvd, Ste 2, Jacksonville, FL 32216-2705 | 2005-05-24 |
| 1013542919 | Ackerman Cancer Center, Pa | Urology | 10232 San Jose Blvd, Jacksonville, FL 32257 | 2020-03-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
Please comment or provide details below to improve the information on INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC.
| 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.