Organization Active NPI

Jefferson Cardiovascular and Thoracic Services

  • Cardiovascular Disease Physician
  • Festus, MO
National Provider Identifier
1679836381
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
JEFFERSON CARDIOVASCULAR AND THORACIC SERVICES
Practice address
1390 US Highway 61
Suite 3301
Festus, MO 63028-4137
Phone
(636) 931-6302
Fax
(636) 933-5055
NPI assigned
Jun 18, 2012
Last updated
Jun 18, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
JEFFERSON REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Authorized official

Name
Mr. Daniel Steve Eckenfels
Title
Chief Financial Officer
Phone
(636) 933-1107

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X
Interventional Cardiology Physician 207RI0011X
Nuclear Cardiology Physician 207UN0901X

Addresses

Primary practice location

1390 US Highway 61
Suite 3301
Festus, MO 63028-4137

Mailing address

1390 US Highway 61
Suite 3301
Festus, MO 63028-4137
Phone (636) 931-6302

National Provider Directory

National Provider Directory
Part of
Jefferson Med Services

Locations

1390 US Highway 61
Ste 3301
Crystal Cty, MO 63028
Phone (636) 931-6302

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1679836381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 US HIGHWAY 61",
            "address_2": "SUITE 3301",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284137",
            "telephone_number": "636-931-6302",
            "fax_number": "636-933-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 US HIGHWAY 61",
            "address_2": "SUITE 3301",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284137",
            "telephone_number": "636-931-6302",
            "fax_number": "636-933-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON CARDIOVASCULAR AND THORACIC SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEFFERSON REGIONAL MEDICAL CENTER",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "ECKENFELS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "STEVE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "636-933-1107",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.