Radial First Cardiovascular Associates, LLC

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

M11673 Issued in ID

Legal business name

RADIAL FIRST CARDIOVASCULAR ASSOCIATES, LLC

Practice address

2001 S Woodruff Ave
Suite 3
Idaho Falls, ID 83404-6371

Phone

(208) 523-3050

Fax

(208) 523-4985

NPI assigned

Jul 16, 2015

Organization subpart

No

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

Authorized official

Name

Dr. John E Lassetter, M.D.

Title

Medical Director

Phone

(480) 318-7757

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1730563909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE",
            "address_2": "SUITE 3",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046371",
            "telephone_number": "208-523-3050",
            "fax_number": "208-523-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE",
            "address_2": "SUITE 3",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046371",
            "telephone_number": "208-523-3050",
            "fax_number": "208-523-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIAL FIRST CARDIOVASCULAR ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "LASSETTER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "480-318-7757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "ID",
            "license": "M11673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M11673",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1477578300",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheyanne Rachuna, RBT
• Amy Radford
• Bradley Radford, FNP-BC
• Carmen Radford, LNP
• Joan Radford
• Radial First Holdings
• Benjamin Garfield Rae IV
• Casey Ragan, M.S., CF-SLP
• Sunny Raichart, FNP
• Denis P Raleigh, MD

• Interventional Cardiology Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Interventional Cardiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.