Cardiac Cath Lab of Idaho Falls

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

CARDIAC CATH LAB OF IDAHO FALLS

Practice address

3311 Valencia Drive
Idaho Falls, ID 83404

Phone

(415) 218-9820

NPI assigned

Sep 5, 2018

Organization subpart

No

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

Authorized official

Name

Eric Fournet

Title

Chief Financial Officer

Phone

(713) 574-1015

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536105600000",
    "number": "1609358761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 POST OAK BLVD STE 1525",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770564711",
            "telephone_number": "713-574-1015",
            "fax_number": "832-271-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 VALENCIA DRIVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "415-218-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIAC CATH LAB OF IDAHO FALLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-05",
        "last_updated": "2018-09-05",
        "status": "A",
        "authorized_official_last_name": "FOURNET",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "713-574-1015"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Mark Capener, DMD
• Mark Lee Capener, M.D.
• Elisabeth Capron, IBCLC, RN, CPN
• Heather Capson
• Lauren Capson
• Kylee Cardon
• Carepoint Inpatient Blue Sky Neurology Idaho, LLC
• Kryston Chenay Carling, PHARMD
• Cody Lee Carlson, LPC
• Jessica C. Carlson, L.P.C.

• Interventional Cardiology Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Interventional Cardiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.