The Cardiovascular Clinic of West Tennessee,P.C.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

36918 Issued in TN

Legal business name

THE CARDIOVASCULAR CLINIC OF WEST TENNESSEE,P.C.

Doing business as

West Tennessee Cardiovascular Clinic

Practice address

162 Murray Guard Dr
Suite a
Jackson, TN 38305-3609

Phone

(731) 256-1819

Fax

(731) 664-4330

NPI assigned

Jun 17, 2007

Last updated

Aug 1, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Adeyinka Adebayo Agbetoyin, M.D.NPI 1922047422

Title

President

Phone

(731) 256-1819

Specialties & licenses 1

Addresses

Other names 1

• WEST TENNESSEE CARDIOVASCULAR CLINIC Doing business as

Practitioners 3

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.

• Adeyinka Adebayo Agbetoyin, MD

  • Cardiovascular Disease Physician
  • Jackson, TN
  • NPI 1922047422
  NPD Authorized official
• Randy A Earls, APN

  • Adult Health Nurse Practitioner
  • Union City, TN
  • NPI 1821054669
  NPD (past)
• Nina L White, A.P.R.N.

  • Nurse Practitioner
  • Jackson, TN
  • NPI 1790318590
  NPD (past)

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

{
    "created_epoch": "1182038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1013112457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 DOVECREST CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383056908",
            "telephone_number": "731-256-1819",
            "fax_number": "731-664-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 MURRAY GUARD DR",
            "address_2": "SUITE A",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053609",
            "telephone_number": "731-256-1819",
            "fax_number": "731-664-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CARDIOVASCULAR CLINIC OF WEST TENNESSEE,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-17",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "AGBETOYIN",
        "authorized_official_first_name": "ADEYINKA",
        "authorized_official_middle_name": "ADEBAYO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "731-256-1819",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "36918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEST TENNESSEE CARDIOVASCULAR CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tennessee Vision Partners PLLC (Lifetime EyeCare)
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• Krittika Thakuria, DO
• Leah Tharpe, RN0000144089
• The Children's Clinic of West Tennessee P.a.
• The David Vickery Limited Partnership (Positive Psychology Group)
• The Grove Behavorial Health Services, Inc
• The Medical Clinic of Jackson
• The Pratt Clinic, PLLC (The Pratt Clinic)

• Cardiovascular Disease Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.