Organization Active NPI

Medina Cardiovascular Associates Inc

  • Cardiovascular Disease Physician
  • Medina, OH
National Provider Identifier
1700816824
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MEDINA CARDIOVASCULAR ASSOCIATES INC
Practice address
970 E Washington St Ste 2E
Medina, OH 44256-2181
Phone
(330) 722-8707
Fax
(330) 723-5679
NPI assigned
Jul 4, 2006
Last updated
Sep 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Dr. Than M Jain, MDNPI 1427085570
Title
President
Phone
(330) 722-8707

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
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

970 E Washington St Ste 2E
Medina, OH 44256-2181

Mailing address

970 E Washington St Ste 2E
Medina, OH 44256-2181
Phone (330) 722-8707

Other identifiers 2

IdentifierTypeStateIssuer
2401458MedicaidOH
CA2551OtherOHRAILROAD MEDICARE

Other names 1

  • T M JAIN MD INC Former legal business name

National Provider Directory

National Provider Directory

Locations

221 Elyria St
Lodi, OH 44254
Phone (330) 334-2555

Practitioners & affiliated clinicians

Practitioners 2

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": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1700816824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 E WASHINGTON ST STE 2E",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562181",
            "telephone_number": "330-722-8707",
            "fax_number": "330-723-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 E WASHINGTON ST STE 2E",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562181",
            "telephone_number": "330-722-8707",
            "fax_number": "330-723-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDINA CARDIOVASCULAR ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "THAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-722-8707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2401458",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA2551",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "T M JAIN MD INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.