Consulting Interventional Cardiology LLC

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

5498 Issued in NV

Legal business name

CONSULTING INTERVENTIONAL CARDIOLOGY LLC

Practice address

112 S Water St
#108
Henderson, NV 89015-2312

Phone

(702) 386-6855

Fax

(209) 575-4598

NPI assigned

Apr 13, 2006

Organization subpart

No

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

Authorized official

Name

John Adan, MD

Title

Managing General Partner

Phone

(702) 386-6855

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1083678486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4398",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953524398",
            "telephone_number": "209-575-4575",
            "fax_number": "209-575-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S WATER ST",
            "address_2": "#108",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890152312",
            "telephone_number": "702-386-6855",
            "fax_number": "209-575-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTING INTERVENTIONAL CARDIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "ADAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING GENERAL PARTNER",
        "authorized_official_telephone_number": "702-386-6855",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NV",
            "license": "5498",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "F6379",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AZ",
            "license": "17530",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002002858",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.