Eastern Shore Heart Center

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

EASTERN SHORE HEART CENTER

Practice address

19725 South Greeno Road
Fairhope, AL 36532-3843

Phone

(251) 990-1930

Fax

(251) 990-1931

NPI assigned

Aug 19, 2006

Last updated

Mar 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Craig R Peterson, M.D.NPI 1619923844

Title

Physician /President

Phone

(251) 990-1930

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/gemms-eas01

Practitioners 1

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.

• Craig Raymond Peterson, M.D.

  • Interventional Cardiology Physician
  • Fairhope, AL
  • NPI 1619923844
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1740394105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19725 SOUTH GREENO ROAD",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323843",
            "telephone_number": "251-990-1930",
            "fax_number": "251-990-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19725 SOUTH GREENO ROAD",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323843",
            "telephone_number": "251-990-1930",
            "fax_number": "251-990-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE HEART CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN /PRESIDENT",
        "authorized_official_telephone_number": "251-990-1930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastern Shore Cosmetic Surgery PC
• Eastern Shore Ear, Nose & Throat Clinic, PC
• Eastern Shore Eye Care, PC (Eastern Shore Eye Care)
• Eastern Shore Gastroenterology, P.C.
• Eastern Shore Health Center, LLC (Suzanne Tormoen, MD)
• Eastern Shore Internal Medicine, LLC
• Eastern Shore Medical Specialists, LLC
• Eastern Shore Mental Wellness Center
• Eastern Shore Oral, Facial and Implant Surgery Center, P.C.
• Eastern Shore Orthopaedic Center, P.C.

• Specialist in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.