NPIMap

Organization Active NPI

Cardiovascular Consultants of North Texas, LLP

  • Cardiovascular Disease Physician
  • Grapevine, TX
National Provider Identifier
1528210663
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOVASCULAR CONSULTANTS OF NORTH TEXAS, LLP
Practice address
1600 W College St
Suite 680
Grapevine, TX 76051-3581
Phone
(817) 912-8400
Fax
(817) 912-8410
NPI assigned
Oct 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Authorized official

Name
Dr. Trent L Pettijohn, MDNPI 1265468706
Title
Managing Partner
Phone
(469) 800-4400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1600 W College St
Suite 680
Grapevine, TX 76051-3581

Mailing address

1600 W College St
Suite 680
Grapevine, TX 76051-3581
Phone (817) 912-8400

Other identifiers 1

IdentifierTypeStateIssuer
149212601MedicaidTX

National Provider Directory

National Provider Directory

Locations

2340 E Trinity Mills Rd
Ste 118
Carrollton, TX 75006
Phone (469) 568-0400

6124 W Parker Rd
Ste 234
Plano, TX 75093
Phone (972) 468-9999

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348790400000",
    "number": "1528210663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W COLLEGE ST",
            "address_2": "SUITE 680",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513581",
            "telephone_number": "817-912-8400",
            "fax_number": "817-912-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W COLLEGE ST",
            "address_2": "SUITE 680",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513581",
            "telephone_number": "817-912-8400",
            "fax_number": "817-912-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR CONSULTANTS OF NORTH TEXAS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2012-09-28",
        "status": "A",
        "authorized_official_last_name": "PETTIJOHN",
        "authorized_official_first_name": "TRENT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "469-800-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "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": "149212601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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.