SJC ONCOLOGY SERVICES - GEORGIA, LLC (NPI# 1710196589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710196589 |
| Entity Type | Organization |
| Organization Name | SJC ONCOLOGY SERVICES - GEORGIA, LLC |
| Other Organization Name | F & G ASSOCIATES, LP D/B/A SAVANNAH ONCOLOGY CENTER LTD |
| Practice Address |
225 Candler Drive Suite 100 Savannah GA 31405-6023 |
| Mailing Address |
Po Box 11407 Dept 1622 Birmingham AL 35246-1622 |
| Practice Telephone | 9123521700 |
| Practice Fax Number | 9123548545 |
| Mailing Telephone | 9123521700 |
| Mailing Fax Number | 9123521066 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2019-06-26 |
| Authorized Official Name | MR. GREGORY J SCHAACK (CFO, FINANCE) |
| Authorized Official Telephone | 9128196162 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
61684 | GA | Allopathic & Osteopathic Physicians |
| N | 261QX0200X |
Clinic/Center Specialization: Oncology |
Ambulatory Health Care Facilities | ||
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 300026248A | 05 | |
| GA | RAILROAD MEDICARE | CI8039 | 01 |
| Other Name | Type Code |
|---|---|
| F & G Associates, LP D/B/A Savannah Oncology Center Ltd | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1706 Alice St, Waycross, GA 315015216 | 9123521700 | |
| 225 Candler Dr Ste 301, Savannah, GA 314056091 | 9123521700 | 9123548545 |
| 228 Memorial Dr, Jesup, GA 315450102 | 9123521700 | |
| 5353 Reynolds St Ste 200, Savannah, GA 314056087 | 9128195771 | 9128195772 |
| 5353 Reynolds St Ste 107, Savannah, GA 314056015 | 9128197630 | 9128195860 |
| 16741 Highway 67 Ste G, Statesboro, GA 304582529 | 9123521700 | 9123548545 |
| 225 Candler Dr Ste 100, Savannah, GA 314056093 | 9123521700 |
| Street Address |
225 CANDLER DRIVE SUITE 100 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405-6023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306895073 | Howard A. Zaren | Surgery | 225 Candler Drive, Suite 301, Savannah, GA 31405 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
| Find all providers in zip 31405 | ||||
| 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 |
|---|---|---|---|---|
| 1003903352 | John Joseph Ptacek | Radiology | 61 Hemingway Circle, Savannah, GA 31411 | 2006-10-06 |
| 1083971683 | Matthew H Bertke | Radiology | 4700 Waters Ave, Savannah, GA 31404-6220 | 2012-04-19 |
| 1134485766 | John Cramer Schuler | Radiology | 225 Candler Dr Ste 100, Savannah, GA 31405-6093 | 2012-04-09 |
| 1205104783 | Coastal Cancer Care, LLC | Radiology | 4700 Waters Ave, Savannah, GA 31404-6220 | 2011-12-12 |
| 1023335726 | John Lecraw Mikell | Radiology | 225 Candler Dr Ste 100, Savannah, GA 31405-6093 | 2010-04-21 |
| 1528229788 | Joshua Terry Mckenzie | Radiology | 225 Candler Dr, Suite 100, Savannah, GA 31405-6023 | 2008-06-20 |
| 1770741928 | Michael D Hasselle | Radiology | 4700 Waters Ave, Savannah, GA 31404-6220 | 2008-05-23 |
| 1326211459 | Aaron Watson Pederson | Radiology | 4700 Waters Ave, Savannah, GA 31404 | 2008-04-09 |
| 1790961100 | Savannah Radiation Cancer Care, PC | Radiology | 4700 Waters Ave, Savannah, GA 31404-6220 | 2008-01-16 |
| 1831237148 | John A Pablo | Radiology | 225 Candler Rd, Suite 100, Savannah, GA 31405-6023 | 2007-02-01 |
| Find all providers in SAVANNAH | ||||
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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.