Cardiosom, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

69000012A Issued in IN

Legal business name

CARDIOSOM, LLC

Practice address

17527 River Road
Noblesville, IN 46062-8528

Phone

(317) 219-3360

Fax

(317) 219-3335

NPI assigned

Aug 8, 2006

Organization subpart

No

Name

Mr. Jay Jarrell

Title

President/Coo

Phone

(317) 706-1080

Organizations this organization is a member of, according to the National Provider Directory.

• Pacific Sleep Medicine Services Inc

  • Durable Medical Equipment & Medical Supplies
  • Fountain Valley, CA
  • NPI 1801001953

  Member Of

  NPD member

Locations

• CardioSom of Noblesville Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 10, 2010.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281398400000",
    "number": "1114937893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W. CARMEL DR.",
            "address_2": "SUITE 100",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325504",
            "telephone_number": "317-706-1080",
            "fax_number": "317-574-8674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17527 RIVER ROAD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460628528",
            "telephone_number": "317-219-3360",
            "fax_number": "317-219-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOSOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2010-08-10",
        "status": "A",
        "authorized_official_last_name": "JARRELL",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT/COO",
        "authorized_official_telephone_number": "317-706-1080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IN",
            "license": "69000012A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200835690A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CardioSom of Noblesville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nathaniel Canillas
• Colt Keith Cannon, C.O.T.A.
• Kristin Cannon, OTR
• Misty Cannon
• Braca Benizry Cantor
• Hayley Marie Carey, PHARMD
• Jami Carey
• Kaitlin Renee Carnes, FNP
• Jose Francisco Caro, M.D.
• Andrea Carol

• All providers in Noblesville, IN
• Oxygen Equipment & Supplies (DME) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.