NPIMap

Organization Active NPI

Mid America Heart, PC

  • Cardiovascular Disease Physician
  • O Fallon, IL
National Provider Identifier
1124299615
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MID AMERICA HEART, PC
Practice address
310 N Seven Hills Rd
Suite 150
O Fallon, IL 62269-4111
Phone
(618) 632-1495
Fax
(618) 628-0480
NPI assigned
Mar 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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

Authorized official

Name
Ms. Ann L Lintzenich, LPN
Title
Office Manager
Phone
(618) 632-1495

Specialties & licenses 1

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

Addresses

Primary practice location

310 N Seven Hills Rd
Suite 150
O Fallon, IL 62269-4111

Mailing address

310 N Seven Hills Rd
Suite 150
O Fallon, IL 62269-4111
Phone (618) 632-1495

National Provider Directory

National Provider Directory

Locations

310 N 7 Hills Rd
#150
O Fallon, IL 62269
Phone (618) 233-2220

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224201600000",
    "number": "1124299615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N SEVEN HILLS RD",
            "address_2": "SUITE 150",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622694111",
            "telephone_number": "618-632-1495",
            "fax_number": "618-628-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N SEVEN HILLS RD",
            "address_2": "SUITE 150",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622694111",
            "telephone_number": "618-632-1495",
            "fax_number": "618-628-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID AMERICA HEART, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-10-17",
        "status": "A",
        "authorized_official_last_name": "LINTZENICH",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "618-632-1495",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPN"
    },
    "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 O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.