NPIMap

Organization Active NPI

Cardiosom, LLC

Doing business as CardioSom of Peoria

  • Oxygen Equipment & Supplies (DME)
  • Peoria, IL
National Provider Identifier
1407073182
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
CARDIOSOM, LLC
Doing business as
CardioSom of Peoria
Practice address
5405 N Knoxville Ave
Suite 3
Peoria, IL 61614-5016
Phone
(309) 589-1180
Fax
(309) 589-1189
NPI assigned
Apr 20, 2007
Last updated
Oct 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Mr. Kevin Greisl
Title
Coopresident
Phone
(317) 706-1080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X IL Primary

Addresses

Primary practice location

5405 N Knoxville Ave
Suite 3
Peoria, IL 61614-5016

Mailing address

615 W Carmel Dr
Suite 100
Carmel, IN 46032-2996
Phone (800) 868-1920

Other names 1

  • CardioSom of Peoria Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cardiosom LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

5405 N Knoxville Ave
Ste 3
Peoria, IL 61614
Phone (309) 589-1180

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1407073182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W CARMEL DR",
            "address_2": "SUITE 100",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460322996",
            "telephone_number": "800-868-1920",
            "fax_number": "800-868-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "address_2": "SUITE 3",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145016",
            "telephone_number": "309-589-1180",
            "fax_number": "309-589-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOSOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "GREISL",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "COOPRESIDENT",
        "authorized_official_telephone_number": "317-706-1080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CardioSom of Peoria",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.