NPIMap

Organization Active NPI

Huntsville Cardiovascular Clinic, P. C.

  • Interventional Cardiology Physician
  • Huntsville, AL
National Provider Identifier
1609937945
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
HUNTSVILLE CARDIOVASCULAR CLINIC, P. C.
Practice address
4601 Whitesburg Dr S
Suite 201
Huntsville, AL 35802-1676
Phone
(256) 880-1050
Fax
(256) 880-7477
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Authorized official

Name
Robert Ryder
Title
Revenue Cycle Manager
Phone
(256) 213-4679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0011X Primary

Addresses

Primary practice location

4601 Whitesburg Dr S
Suite 201
Huntsville, AL 35802-1676

Mailing address

4601 Whitesburg Dr S
Suite 201
Huntsville, AL 35802-1676
Phone (256) 880-1050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080219000511 AL Part B Supplier - Clinic/Group Practice 3476546003 Receives reassigned benefits from 18 practitioners
Practice locations: Huntsville, AL

National Provider Directory

National Provider Directory

Locations

2506 Danville Rd SW
Ste 201
Decatur, AL 35603
Phone (256) 880-1050

4601 Whitesburg Dr SE
Ste 200
Huntsville, AL 35802

4601 Whitesburg Dr SE
Ste 201
Huntsville, AL 35802
Phone (256) 880-1050

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638144000000",
    "number": "1609937945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 WHITESBURG DR S",
            "address_2": "SUITE 201",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021676",
            "telephone_number": "256-880-1050",
            "fax_number": "256-880-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 WHITESBURG DR S",
            "address_2": "SUITE 201",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021676",
            "telephone_number": "256-880-1050",
            "fax_number": "256-880-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTSVILLE CARDIOVASCULAR CLINIC, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-11-29",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "RYDER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "256-213-4679"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.