Organization Active NPI

Optima Heartcare, Inc.

  • Cardiovascular Disease Physician
  • Saint Louis, MO
National Provider Identifier
1124015763
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
OPTIMA HEARTCARE, INC.
Practice address
13358 Manchester Rd
Suite 120
Saint Louis, MO 63131-1730
Phone
(314) 965-3023
Fax
(314) 965-1477
NPI assigned
Sep 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Authorized official

Name
Dr. John R. Raabe, M.D.NPI 1689677726
Title
Owner
Phone
(314) 965-3023

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 Primary

Addresses

Primary practice location

13358 Manchester Rd
Suite 120
Saint Louis, MO 63131-1730

Mailing address

13358 Manchester Rd
Suite 120
Saint Louis, MO 63131-1730
Phone (314) 965-3023

National Provider Directory

National Provider Directory

Locations

13358 Manchester Rd
Ste 120
Saint Louis, MO 63131
Phone (314) 965-3023

Practitioners & affiliated clinicians

Practitioners 2

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": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1124015763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13358 MANCHESTER RD",
            "address_2": "SUITE 120",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311730",
            "telephone_number": "314-965-3023",
            "fax_number": "314-965-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13358 MANCHESTER RD",
            "address_2": "SUITE 120",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311730",
            "telephone_number": "314-965-3023",
            "fax_number": "314-965-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMA HEARTCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "RAABE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-965-3023",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.