Organization Active NPI

Mountain Heart Center, PSC

  • Cardiovascular Disease Physician
  • Whitesburg, KY
National Provider Identifier
1104831775
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
29202 Issued in KY
Legal business name
MOUNTAIN HEART CENTER, PSC
Practice address
714 Jenkins Rd
Whitesburg, KY 41858-7189
Phone
(606) 633-5520
Fax
(606) 633-5515
NPI assigned
Jul 30, 2006
Last updated
Apr 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Authorized official

Name
Dr. Padubidri S Chandrashekar, M.D.NPI 1912993585
Title
President
Phone
(606) 633-5520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 29202 KY Primary

Addresses

Primary practice location

714 Jenkins Rd
Whitesburg, KY 41858-7189

Mailing address

PO Box 767
Whitesburg, KY 41858-0767
Phone (606) 633-5520

Other identifiers 1

IdentifierTypeStateIssuer
65929432MedicaidKY

National Provider Directory

National Provider Directory

Locations

221 Industrial Park Rd
Harlan, KY 40831
Phone (606) 573-5501

3777 N Mayo Trl
Pikeville, KY 41501
Phone (606) 432-1500

Practitioners & affiliated clinicians

Practitioners 2

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": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1104831775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 767",
            "city": "WHITESBURG",
            "state": "KY",
            "postal_code": "418580767",
            "telephone_number": "606-633-5520",
            "fax_number": "606-633-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 JENKINS RD",
            "city": "WHITESBURG",
            "state": "KY",
            "postal_code": "418587189",
            "telephone_number": "606-633-5520",
            "fax_number": "606-633-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HEART CENTER, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "CHANDRASHEKAR",
        "authorized_official_first_name": "PADUBIDRI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-633-5520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "29202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65929432",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitesburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.