Cardiac Imaging Center, PLLC.

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

01010/4730849-01 Issued in WV

Legal business name

CARDIAC IMAGING CENTER, PLLC.

Practice address

331 Laidley St
Suite 402
Charleston, WV 25301-1619

Phone

(304) 419-0395

NPI assigned

Jan 15, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Bassam Moushmoush, M.D.

Title

Owner

Phone

(304) 419-0395

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1093991564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 LAIDLEY ST",
            "address_2": "SUITE 402",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011619",
            "telephone_number": "304-419-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 LAIDLEY ST",
            "address_2": "SUITE 402",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011619",
            "telephone_number": "304-419-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIAC IMAGING CENTER, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "MOUSHMOUSH",
        "authorized_official_first_name": "BASSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-419-0395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "WV",
            "license": "01010/4730849-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073986000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Allene Capps, MA, CAC
• Rayanna Capral
• Brandon Phillip Carag, PA-C
• David Lee Caraway, MD
• Amber R Cardenas
• Alejandra Victoria Cardona Perez, MD
• Chastity Cardona
• Norbert J Cardoso, M.D.
• Ivanna Cardwell
• Yolonda Cardwell

• Physiological Laboratory in Charleston, WV
• Providers in Charleston, WV by specialty
• Physiological Laboratory in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.