Rising Phoenix Heart Institute, SC

Primary specialty

SpecialistTaxonomy code 174400000X

License

34544 Issued in WI

Legal business name

RISING PHOENIX HEART INSTITUTE, SC

Practice address

2323 S 109TH St
Suite 195
West Allis, WI 53227-1909

Phone

(414) 541-7158

Fax

(414) 541-7514

NPI assigned

Dec 26, 2007

Organization subpart

No

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

Authorized official

Name

Nadia Moussavi, MD

Title

President / Owner

Phone

(414) 541-7158

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381968000000",
    "number": "1659555712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 S 109TH ST",
            "address_2": "SUITE 195",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271909",
            "telephone_number": "414-541-7158",
            "fax_number": "414-541-7514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 S 109TH ST",
            "address_2": "SUITE 195",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271909",
            "telephone_number": "414-541-7158",
            "fax_number": "414-541-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISING PHOENIX HEART INSTITUTE, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2013-10-17",
        "status": "A",
        "authorized_official_last_name": "MOUSSAVI",
        "authorized_official_first_name": "NADIA",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "414-541-7158",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WI",
            "license": "34544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110200829",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32454600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Niccole Rietveld, PTA
• Rif Home Care LLC
• Javier A Rincon, MD
• Erika Jeannette Riobo Gomez, LPC
• Rising Phoenix Heart Institute
• Dana Ann Ritzman, RN
• River Bend Shoe Center
• River of Change Counseling and Life Coaching Services Inc.
• Angela Rivera
• Victoria E Rizk, PA-C

• Specialist in West Allis, WI
• Providers in West Allis, WI by specialty
• Specialist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; 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.