Mamidi Cardiology PLLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

WV12853 Issued in WV

Legal business name

MAMIDI CARDIOLOGY PLLC

Practice address

20 Hospital Dr
Logan, WV 25601

Phone

(304) 831-2300

Fax

(304) 831-2303

NPI assigned

Jul 5, 2006

Organization subpart

No

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

Authorized official

Name

Satyanarayana Mamidi, MD

Title

Owner

Phone

(304) 831-2300

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316978745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HOSPITAL DR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "25601",
            "telephone_number": "304-831-2300",
            "fax_number": "304-831-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HOSPITAL DR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "25601",
            "telephone_number": "304-831-2300",
            "fax_number": "304-831-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMIDI CARDIOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAMIDI",
        "authorized_official_first_name": "SATYANARAYANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-831-2300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WV",
            "license": "WV12853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083504000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Logan, WV
• Providers in Logan, WV by specialty
• Cardiovascular Disease Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.