Christian Cardiovascular Institute PC

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

Organization subpart

No

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.

Title

President

Phone

(405) 947-2228

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julie Anne Meritt, P.A.

  • Physician Assistant
  • Midwest City, OK
  • NPI 1003009960
  NPD (past)

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10012360A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DP6097",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blake Dalbert Christensen, D.O.
• Molly Kate Christensen
• Robert Jay Christensen, M.D.
• Sarah Jacquelin Christensen, MD
• Kahlene Marie Christenson, APRN, CNP
• Christian Clinic for Counseling, Inc
• Adrian Christian
• Linda Hartz Christian, LPC
• Sarah Christian
• Sharlene J Christiansen

• Cardiovascular Disease Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Cardiovascular Disease Physician in Oklahoma

• 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.