Organization Active NPI

Christian Cardiovascular Institute PC

  • Cardiovascular Disease Physician
  • Oklahoma City, OK
National Provider Identifier
1225201718
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
17642 Issued in OK
Legal business name
CHRISTIAN CARDIOVASCULAR INSTITUTE PC
Practice address
3300 NW 56TH Street
Suite 200
Oklahoma City, OK 73112-4401
Phone
(405) 947-2228
Fax
(405) 947-2307
NPI assigned
Apr 7, 2008
Last updated
Feb 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Authorized official

Name
Dr. Dominic M. Pedulla, M.D.NPI 1558321489
Title
President
Phone
(405) 947-2228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 17642 OK Primary

Addresses

Primary practice location

3300 NW 56TH Street
Suite 200
Oklahoma City, OK 73112-4401

Mailing address

3300 NW 56TH Street
Suite 200
Oklahoma City, OK 73112-4401
Phone (405) 947-2228

National Provider Directory

National Provider Directory

Locations

3300 NW 56th St
Ste 280
Oklahoma City, OK 73112
Phone (405) 604-0688

3366 NW Expressway
Ste 630
Oklahoma City, OK 73112
Phone 40059472228

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518998400000",
    "number": "1225201718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 NW 56TH STREET",
            "address_2": "SUITE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124401",
            "telephone_number": "405-947-2228",
            "fax_number": "405-947-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NW 56TH STREET",
            "address_2": "SUITE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124401",
            "telephone_number": "405-947-2228",
            "fax_number": "405-947-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN CARDIOVASCULAR INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2018-02-19",
        "status": "A",
        "authorized_official_last_name": "PEDULLA",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-947-2228",
        "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": "OK",
            "license": "17642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; 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.