Organization Active NPI

Tennessee Valley Cardiovascular Center, PC

  • Cardiovascular Disease Physician
  • Sheffield, AL
National Provider Identifier
1255417598
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
23786 Issued in AL
Legal business name
TENNESSEE VALLEY CARDIOVASCULAR CENTER, PC
Practice address
1120 S Jackson Hwy
Suite 302
Sheffield, AL 35660-5777
Phone
(256) 383-8066
Fax
(256) 383-8727
NPI assigned
Oct 30, 2006
Last updated
Apr 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Tammy Varie Haddock
Title
Credentials Specialist
Phone
(256) 766-2118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 23786 AL Primary

Addresses

Primary practice location

1120 S Jackson Hwy
Suite 302
Sheffield, AL 35660-5777

Mailing address

1120 S Jackson Hwy
Suite 302
Sheffield, AL 35660-5777
Phone (256) 383-8066

Other identifiers 1

IdentifierTypeStateIssuer
529202460MedicaidAL

National Provider Directory

National Provider Directory

Locations

1120 S Jackson Hwy
Ste 204
Sheffield, AL 35660
Phone (256) 381-8811

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": "1162166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1255417598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S JACKSON HWY",
            "address_2": "SUITE 302",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "356605777",
            "telephone_number": "256-383-8066",
            "fax_number": "256-383-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S JACKSON HWY",
            "address_2": "SUITE 302",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "356605777",
            "telephone_number": "256-383-8066",
            "fax_number": "256-383-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE VALLEY CARDIOVASCULAR CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-30",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "HADDOCK",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "VARIE",
        "authorized_official_title_or_position": "CREDENTIALS SPECIALIST",
        "authorized_official_telephone_number": "256-766-2118"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "23786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529202460",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheffield, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.