NPIMap

Organization Active NPI

Midwest Cardiovascular Constultants, LLC

Doing business as CardioCare Consultants

  • Cardiovascular Disease Physician
  • Perrysburg, OH
National Provider Identifier
1639213978
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MIDWEST CARDIOVASCULAR CONSTULTANTS, LLC
Doing business as
CardioCare Consultants
Practice address
1601 Brigham Dr
Suite 120
Perrysburg, OH 43551-7114
Phone
(419) 872-7703
Fax
(419) 872-1704
NPI assigned
Feb 19, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kimberly A Govan
Title
Credentialing Specialist
Phone
(419) 824-7221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X OH Primary

Addresses

Primary practice location

1601 Brigham Dr
Suite 120
Perrysburg, OH 43551-7114

Mailing address

1601 Brigham Dr
Suite 120
Perrysburg, OH 43551-7114
Phone (419) 872-7703

Other identifiers 3

IdentifierTypeStateIssuer
DA2406OtherOHRRMC
7663459OtherOHAETNA
2421605MedicaidOH

Other names 1

  • CardioCare Consultants Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cardiocare Consultants3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639213978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BRIGHAM DR",
            "address_2": "SUITE 120",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435517114",
            "telephone_number": "419-872-7703",
            "fax_number": "419-872-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRIGHAM DR",
            "address_2": "SUITE 120",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435517114",
            "telephone_number": "419-872-7703",
            "fax_number": "419-872-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST CARDIOVASCULAR CONSTULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOVAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "419-824-7221"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "DA2406",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7663459",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2421605",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CardioCare Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perrysburg, OH

Sources for this page

  • 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.