Cardio Terra, LTD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

CARDIO TERRA, LTD

Practice address

4112 Monroe Rd
Celina, OH 45822-9250

Phone

(567) 890-9000

Fax

(567) 890-9009

NPI assigned

Nov 12, 2013

Last updated

Jan 8, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Joe Boley, M.D.NPI 1962465435

Title

Member

Phone

(614) 850-0081

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerry Joe Boley, M.D.

  • Cardiovascular Disease Physician
  • Celina, OH
  • NPI 1962465435
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1194155135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 MONROE RD",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458229250",
            "telephone_number": "567-890-9000",
            "fax_number": "567-890-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 MONROE RD",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458229250",
            "telephone_number": "567-890-9000",
            "fax_number": "567-890-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIO TERRA, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "BOLEY",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "614-850-0081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307108",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany N Bullock, STNA
• Felicia Marie Burnett, MS, LPCC-S
• Sara Burt
• Adalyn Byrd
• Cancer Network of West Central Ohio (Grand Lake Regional Cancer Center)
• Rosario del Carmen Ruiz Casanova
• Mary Cassada
• Cora Elizabeth Casto, DC
• Celina Al Opco LLC (Celina Assisted Living)
• Celina Al, LLC (Trustwell Living at Miller Place)

• Cardiovascular Disease Physician in Celina, OH
• Providers in Celina, OH by specialty
• Cardiovascular Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.