Central Georgia Heart Institue, LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

041593 Issued in GA

Legal business name

CENTRAL GEORGIA HEART INSTITUE, LLC

Practice address

1707 Watson Blvd Ste 200
Warner Robins, GA 31093-3607

Phone

(478) 929-8030

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Misty Sanders

Title

Office Manger

Phone

(478) 293-4739

Specialties & licenses 6

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IBFHCA

Practitioners 10

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

• Nisreen A Jallad, M.D, FACC

  • Interventional Cardiology Physician
  • Warner Robins, GA
  • NPI 1598943045

  Cardiovascular Disease, GA

  Medicare reassignment Care Compare group NPD
• Rahil Kazi, M.D.

  • Cardiovascular Disease Physician
  • Warner Robins, GA
  • NPI 1629034079

  Cardiovascular Disease, GA

  Medicare reassignment Care Compare group NPD
• April Gaddy Jones, NP-C

  • Adult Health Nurse Practitioner
  • Warner Robins, GA
  • NPI 1801101621

  GA

  Medicare reassignment NPD
• Brittany Joi Banichar, NP

  • Acute Care Nurse Practitioner
  • Warner Robins, GA
  • NPI 1578158101
  NPD
• Ashley Cooper Chancellor, NP

  • Family Nurse Practitioner
  • Warner Robins, GA
  • NPI 1669982054
  NPD
• John Marshall Smith II

  • Family Nurse Practitioner
  • Macon, GA
  • NPI 1942739768
  NPD
• Bonnie G. Bower, NP

  • Nurse Practitioner
  • Warner Robins, GA
  • NPI 1326091554
  NPD (past)
• Javed H. Fazal, M.D.

  • Internal Medicine Physician
  • Warner Robins, GA
  • NPI 1942243704

  Internal Medicine

  NPD (past)
• Fabian R. Franco, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Bonaire, GA
  • NPI 1649237207
  NPD (past)
• Kaelyn Grace Kinser, FNP-C

  • Cardiovascular Disease Physician
  • Warner Robins, GA
  • NPI 1558206516

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669766400000",
    "number": "1659313153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 WATSON BLVD",
            "address_2": "SUITE 200",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933606",
            "telephone_number": "478-929-8030",
            "fax_number": "478-929-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 WATSON BLVD STE 200",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933607",
            "telephone_number": "478-929-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL GEORGIA HEART INSTITUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "OFFICE MANGER",
        "authorized_official_telephone_number": "478-293-4739",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "051049",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "049348",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "047951",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "041593",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "052467",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "GA",
            "license": "052467",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "misty@kazimd.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1707 Watson Blvd",
            "city": "Warner Robins",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310933606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mist@kazimd.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1707 Watson Blvd Ste 200",
            "city": "Warner Robins",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310933607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Warner Robins, GA
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.