Cardiovascular Diagnostic Center

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

CARDIOVASCULAR DIAGNOSTIC CENTER

Practice address

1099 S Township Blvd
Jenkins TWP, PA 18640-3247

Phone

(570) 654-6759

Fax

(570) 655-5160

NPI assigned

Nov 30, 2007

Organization subpart

No

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

Authorized official

Name

Gerald Gibbons, M.D.

Title

President

Phone

(570) 654-6759

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Mark M Bernardi, DO

  • Interventional Cardiology Physician
  • Aurora, IL
  • NPI 1750375606
  NPD

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1609058734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 S TOWNSHIP BLVD",
            "city": "JENKINS TWP",
            "state": "PA",
            "postal_code": "186403247",
            "telephone_number": "570-654-6759",
            "fax_number": "570-655-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 S TOWNSHIP BLVD",
            "city": "JENKINS TWP",
            "state": "PA",
            "postal_code": "186403247",
            "telephone_number": "570-654-6759",
            "fax_number": "570-655-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR DIAGNOSTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "GIBBONS",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-654-6759",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "813246",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.