NPIMap

Organization Active NPI

Heart Clinic of Louisville, PSC

  • Cardiovascular Disease Physician
  • Jeffersonville, IN
National Provider Identifier
1063687176
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01040911A Issued in IN
Legal business name
HEART CLINIC OF LOUISVILLE, PSC
Practice address
601 N Shore Dr
Suite 102
Jeffersonville, IN 47130-3142
Phone
(812) 218-9845
Fax
(812) 218-9850
NPI assigned
Apr 29, 2008
Last updated
May 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Authorized official

Name
Dr. Wayne Gibson, MD
Title
Owner
Phone
(812) 218-9845

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 01040911A IN Primary

Addresses

Primary practice location

601 N Shore Dr
Suite 102
Jeffersonville, IN 47130-3142

Mailing address

601 N Shore Dr
Suite 102
Jeffersonville, IN 47130-3142
Phone (812) 218-9845

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367798400000",
    "number": "1063687176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N SHORE DR",
            "address_2": "SUITE 102",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303142",
            "telephone_number": "812-218-9845",
            "fax_number": "812-218-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N SHORE DR",
            "address_2": "SUITE 102",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303142",
            "telephone_number": "812-218-9845",
            "fax_number": "812-218-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART CLINIC OF LOUISVILLE, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2013-05-06",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-218-9845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01040911A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.