Organization Active NPI

Collier Heart Group, PLLC

  • Interventional Cardiology Physician
  • Naples, FL
National Provider Identifier
1104881341
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
COLLIER HEART GROUP, PLLC
Practice address
311 9TH St N
Suite 304
Naples, FL 34102-5885
Phone
(239) 659-0102
Fax
(239) 659-0108
NPI assigned
Apr 19, 2006
Organization subpart
No

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
Dr. David R. Axline, M.D.
Title
Partner
Phone
(239) 659-0102

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X Primary

Addresses

Primary practice location

311 9TH St N
Suite 304
Naples, FL 34102-5885

Mailing address

PO Box 850001
Orlando, FL 32885-0001
Phone (239) 659-0102

Other identifiers 2

IdentifierTypeStateIssuer
00793OtherFLBCBS
DE1357OtherFLRR MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1104881341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328850001",
            "telephone_number": "239-659-0102",
            "fax_number": "239-659-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 9TH ST N",
            "address_2": "SUITE 304",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025885",
            "telephone_number": "239-659-0102",
            "fax_number": "239-659-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIER HEART GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "AXLINE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "239-659-0102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00793",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DE1357",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

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.