Jacksonville Cardiovascular Center PL

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

JACKSONVILLE CARDIOVASCULAR CENTER PL

Practice address

4131 University Blvd S Ste 17
Jacksonville, FL 32216-4346

Phone

(904) 805-9600

Fax

(904) 805-0084

NPI assigned

Nov 2, 2006

Last updated

Apr 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Waddah Salman, MDNPI 1568441012

Title

Owner

Phone

(904) 805-9600

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

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.

• Waddah Salman, MD

  • Interventional Cardiology Physician
  • Jacksonville, FL
  • NPI 1568441012
  Medicare reassignment Care Compare group NPD Authorized official
• Simmy Regin Varghese

  • Acute Care Nurse Practitioner
  • Jacksonville, FL
  • NPI 1306443916
  Medicare reassignment Care Compare group NPD
• Claudia Van Dalen, PA-C

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1649052994
  Medicare reassignment Care Compare group
• Margaret Brassinga, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1184508020
  Medicare reassignment NPD
• Meredith Kathleen Jones, DNP, APRN

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1982297230
  Medicare reassignment NPD
• Kimberly R Pierce, APRN

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1629260732
  Medicare reassignment NPD
• Michael Walker, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1922630128
  Medicare reassignment NPD

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1447339528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6444 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162891",
            "telephone_number": "904-805-9600",
            "fax_number": "904-805-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 UNIVERSITY BLVD S STE 17",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164346",
            "telephone_number": "904-805-9600",
            "fax_number": "904-805-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE CARDIOVASCULAR CENTER PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "SALMAN",
        "authorized_official_first_name": "WADDAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-805-9600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME53377",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003247500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.