NPIMap

Organization Active NPI

Arizona Heart Institute Lake Havasu

  • Cardiovascular Disease Physician
  • Lake Havasu City, AZ
National Provider Identifier
1053512632
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ARIZONA HEART INSTITUTE LAKE HAVASU
Practice address
1845 McCulloch Blvd N
Suite A6
Lake Havasu City, AZ 86403-6759
Phone
(520) 505-4442
Fax
(602) 240-6177
NPI assigned
May 30, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
ARIZONA HEART INSTITUTE LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Ken Walsh
Title
Cfo
Phone
(602) 266-2200

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X
Cardiovascular Disease Physician 207RC0000X Primary
Interventional Cardiology Physician 207RI0011X
Nuclear Cardiology Physician 207UN0901X

Addresses

Primary practice location

1845 McCulloch Blvd N
Suite A6
Lake Havasu City, AZ 86403-6759

Mailing address

PO Box 61773
Phoenix, AZ 85082-1773
Phone (602) 682-6727

National Provider Directory

National Provider Directory
Tax ID family
Ariz Heart Inst LTD13 organizations share this tax ID, including this one
Part of
Ariz Heart Inst LTD

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1845 McCulloch Blvd N
Ste A6
Lake Havasu City, AZ 86403
Phone (520) 505-4442

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1053512632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61773",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850821773",
            "telephone_number": "602-682-6727",
            "fax_number": "602-240-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 MCCULLOCH BLVD N",
            "address_2": "SUITE A6",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036759",
            "telephone_number": "520-505-4442",
            "fax_number": "602-240-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA HEART INSTITUTE LAKE HAVASU",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA HEART INSTITUTE LTD",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "602-266-2200"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.