NPIMap

Organization Active NPI

Huntsville Cardiovascular Clinic, P.C.

  • Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1114355120
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-109897 Issued in AL
Legal business name
HUNTSVILLE CARDIOVASCULAR CLINIC, P.C.
Practice address
4601 Whitesburg Dr SE
Suite 201
Huntsville, AL 35802-1676
Phone
(256) 880-1050
NPI assigned
Oct 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Authorized official

Name
Rebecca Hedrick
Title
Administrator
Phone
(256) 880-1050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 1-109897 AL Primary

Addresses

Primary practice location

4601 Whitesburg Dr SE
Suite 201
Huntsville, AL 35802-1676

Mailing address

4601 Whitesburg Dr SE
Suite 201
Huntsville, AL 35802-1676
Phone (256) 880-1050

Other identifiers 1

IdentifierTypeStateIssuer
1-109897OtherALCRNP COLLABORATIVE PRACTICE LICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1114355120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 WHITESBURG DR SE",
            "address_2": "SUITE 201",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021676",
            "telephone_number": "256-880-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 WHITESBURG DR SE",
            "address_2": "SUITE 201",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021676",
            "telephone_number": "256-880-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTSVILLE CARDIOVASCULAR CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-30",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "HEDRICK",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "256-880-1050"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-109897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP COLLABORATIVE PRACTICE LICENSE",
            "identifier": "1-109897",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.