NPIMap

Organization Active NPI

Just Heart Cardiovascular Group Inc.

  • Specialist
  • Baltimore, MD
National Provider Identifier
1659318152
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0053981 Issued in MD
Legal business name
JUST HEART CARDIOVASCULAR GROUP INC.
Practice address
300 Armory PL
Suite 3M
Baltimore, MD 21201-4603
Phone
(410) 225-8615
Fax
(410) 462-5095
NPI assigned
Jun 1, 2006
Last updated
Jan 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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

Authorized official

Name
Camellus O Ezeugwu, M.D.NPI 1194720110
Title
Ceo
Phone
(410) 225-8615

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D0053981 MD Primary

Addresses

Primary practice location

300 Armory PL
Suite 3M
Baltimore, MD 21201-4603

Mailing address

PO Box 6545
Ellicott City, MD 21042-0545
Phone (410) 225-8615

Other identifiers 1

IdentifierTypeStateIssuer
404322700MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000633 MD Part B Supplier - Clinic/Group Practice 7416854286 Receives reassigned benefits from 3 practitioners
Practice locations: Baltimore, MD; Pikesville, MD

National Provider Directory

National Provider Directory

Locations

1940 W Baltimore St
Fl 2
Baltimore, MD 21223
Phone (410) 362-3187

300 Armory Pl
Ste 2M
Baltimore, MD 21201
Phone (410) 225-8615

2 Reservoir Cir
Ste 105
Pikesville, MD 21208
Phone (410) 435-0512

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6661/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294099200000",
    "number": "1659318152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6545",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210420545",
            "telephone_number": "410-225-8615",
            "fax_number": "410-462-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ARMORY PL",
            "address_2": "SUITE 3M",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014603",
            "telephone_number": "410-225-8615",
            "fax_number": "410-462-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUST HEART CARDIOVASCULAR GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2011-01-04",
        "status": "A",
        "authorized_official_last_name": "EZEUGWU",
        "authorized_official_first_name": "CAMELLUS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-225-8615",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0053981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404322700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; 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.