Fairfield Cardiac Cath Lab

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

FAIRFIELD CARDIAC CATH LAB

Practice address

3000 Mack Road
Suite 200
Fairfield, OH 45014

Phone

(513) 603-8888

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Brenda L Vandeventer, RN MSN

Title

Executive Director

Phone

(513) 603-8888

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497823975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MACK ROAD",
            "address_2": "SUITE 200",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "45014",
            "telephone_number": "513-603-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MACK ROAD",
            "address_2": "SUITE 200",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "45014",
            "telephone_number": "513-603-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD CARDIAC CATH LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANDEVENTER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "513-603-8888",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN MSN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2383424",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Clinic/Center in Ohio

• 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.