South Charleston Cardiodiagnostics

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SOUTH CHARLESTON CARDIODIAGNOSTICS

Practice address

428 Division St
1St Floor
South Charleston, WV 25309-1469

Phone

(304) 766-9617

Fax

(304) 766-9626

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Karen Wazir, RN

Title

Office Manager

Phone

(304) 766-3688

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anand Chockalingam, MD

  • Cardiovascular Disease Physician
  • Charleston, WV
  • NPI 1669409108
  NPD (past)
• John Lee Goad, MD

  • Interventional Cardiology Physician
  • Charleston, WV
  • NPI 1588627459
  NPD (past)
• Gina Lee Lathey, APRN FNP-BC

  • Family Nurse Practitioner
  • Scott Depot, WV
  • NPI 1235326901
  NPD (past)
• Frances Nicole Pauley, PA-C

  • Physician Assistant
  • South Charleston, WV
  • NPI 1992254494
  NPD (past)
• James Jarrett Pettit II, MD

  • Internal Medicine Physician
  • Charleston, WV
  • NPI 1316900749
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407079304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 DIVISION ST",
            "address_2": "1ST FLOOR",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091469",
            "telephone_number": "304-766-9617",
            "fax_number": "304-766-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 DIVISION ST",
            "address_2": "1ST FLOOR",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091469",
            "telephone_number": "304-766-9617",
            "fax_number": "304-766-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CHARLESTON CARDIODIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAZIR",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-766-3688",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010978000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5272533",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad Sons
• Tiffany Ellen Sorgman
• Yezenia Soto, APRN-BC
• David Leon Soulsby, M.D.
• Sound Physicians Emergency Medicine of West Virginia PLLC
• South Charleston Cardiology Associates
• South Charleston Dermatology PLLC
• South Charleston Family Medicine
• South Charleston Primary Care
• South Charleston Primary Care Associates

• Clinical Medical Laboratory in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Clinical Medical Laboratory 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.