Centric Heart & Vascular LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

2002015751 Issued in MO

Legal business name

CENTRIC HEART & VASCULAR LLC

Practice address

2103 Silva LN
Moberly, MO 65270-3660

Phone

(660) 616-0022

NPI assigned

Mar 20, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Sanjeev Dhari Ravipudi, MD

Title

Owner

Phone

(626) 394-6299

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521504000000",
    "number": "1356845945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 SILVA LN",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652703660",
            "telephone_number": "660-616-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 SILVA LN",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652703660",
            "telephone_number": "660-616-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRIC HEART & VASCULAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-20",
        "status": "A",
        "authorized_official_last_name": "RAVIPUDI",
        "authorized_official_first_name": "SANJEEV",
        "authorized_official_middle_name": "DHARI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-394-6299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2002015751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Moberly, MO
• Providers in Moberly, MO by specialty
• Cardiovascular Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.