NPIMap

Organization Active NPI

Providence Cardiology Testing

  • Cardiovascular Disease Physician
  • Providence, RI
National Provider Identifier
1316017874
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4568 Issued in RI
Legal business name
PROVIDENCE CARDIOLOGY TESTING
Practice address
1 Randall SQ
Suite 305
Providence, RI 02904-2709
Phone
(401) 521-0700
Fax
(401) 521-0906
NPI assigned
Nov 9, 2006
Last updated
Mar 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Authorized official

Name
Mr. Jack Hug Klie, MDNPI 1992876080
Title
President
Phone
(401) 521-0700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4568 RI Primary

Addresses

Primary practice location

1 Randall SQ
Suite 305
Providence, RI 02904-2709

Mailing address

1 Randall SQ
Suite 305
Providence, RI 02904-2709
Phone (401) 521-0700

Other identifiers 3

IdentifierTypeStateIssuer
90002630MedicaidRI
001218OtherRIBLUE CHIP
849OtherRIBLUE CROSS

National Provider Directory

National Provider Directory
Tax ID family
Providence Cardiology Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1 Randall Sq
Ste 305
Providence, RI 02904
Phone (401) 223-0223

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236816000000",
    "number": "1316017874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RANDALL SQ",
            "address_2": "SUITE 305",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042709",
            "telephone_number": "401-521-0700",
            "fax_number": "401-521-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RANDALL SQ",
            "address_2": "SUITE 305",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042709",
            "telephone_number": "401-521-0700",
            "fax_number": "401-521-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE CARDIOLOGY TESTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2009-03-12",
        "status": "A",
        "authorized_official_last_name": "KLIE",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "HUG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-521-0700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "RI",
            "license": "4568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90002630",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "001218",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "849",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.