Active NPI
Cardio of Clark & Champaign
- Cardiovascular Disease Physician
- Xenia, OH
National Provider Identifier
1467640680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- CARDIO OF CLARK & CHAMPAIGN
- Practice address
- 1141 N Monroe Dr
Xenia, OH 45385-1619 - Phone
- (937) 376-8336
- Fax
- (937) 376-8352
- NPI assigned
- Oct 12, 2007
- Organization subpart
- Yes
- Parent organization
- CARDIOLOGISTS OF CLARK & CHAMPAIGN COUNTIES INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Susan Kae Gabbard, CPC
- Title
- Billing Supervisor
- Phone
- (937) 323-5064
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | Primary |
Addresses
Primary practice location
1141 N Monroe Dr
Xenia, OH 45385-1619
Mailing address
1911 E High St
Springfield, OH 45505-1227
Phone (937) 323-5064
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0942412 | Medicaid | OH | |
| CM7602 | Other | OH | RAILROAD MEDICARE |
National Provider Directory
National Provider Directory- Part of
- Cardio of Clark Champ
Locations
850 E Xenia Dr
Unit 200
Fairborn, OH 45324
Phone (937) 458-4520
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Springfield, OH
- NPI 1417959156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192147200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1201651200000",
"number": "1467640680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1911 E HIGH ST",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455051227",
"telephone_number": "937-323-5064",
"fax_number": "937-323-1407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1141 N MONROE DR",
"city": "XENIA",
"state": "OH",
"postal_code": "453851619",
"telephone_number": "937-376-8336",
"fax_number": "937-376-8352"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARDIO OF CLARK & CHAMPAIGN",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CARDIOLOGISTS OF CLARK & CHAMPAIGN COUNTIES INC",
"enumeration_date": "2007-10-12",
"last_updated": "2008-01-30",
"status": "A",
"authorized_official_last_name": "GABBARD",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "KAE",
"authorized_official_title_or_position": "BILLING SUPERVISOR",
"authorized_official_telephone_number": "937-323-5064",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "CPC"
},
"taxonomies": [
{
"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": "0942412",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CM7602",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Xenia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.