Active NPI
Clarksburg Cardiovascular PLLC
- Cardiovascular Disease Physician
- Bridgeport, WV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- CLARKSBURG CARDIOVASCULAR PLLC
- Practice address
- 527 Medical Park Dr
Ste 306-a
Bridgeport, WV 26330-9008 - Phone
- (304) 933-3830
- Fax
- (304) 933-3837
- NPI assigned
- May 5, 2015
- Last updated
- Jul 29, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Sathyanarayan M Reddy, M.D.
- Title
- Owner
- Phone
- (304) 933-3830
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | Primary |
Addresses
Primary practice location
527 Medical Park Dr
Ste 306-a
Bridgeport, WV 26330-9008
Mailing address
527 Medical Park Dr
Ste 306-a
Bridgeport, WV 26330-9008
Phone (304) 933-3830
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D0967770 | Clarksburg Cardiovascular PLLC | Certificate of waiver | Nov 22, 2027 |
National Provider Directory
National Provider DirectoryLocations
527 Medical Park Dr
Ste 306A
Bridgeport, WV 26330
Phone (304) 933-3830
Practitioners & affiliated clinicians
Practitioners 13
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.
-
- Cardiovascular Disease Physician
- Bridgeport, WV
- NPI 1609828037
-
- Cardiovascular Disease Physician
- Bridgeport, WV
- NPI 1174575484
-
- Physician Assistant
- Clarksburg, WV
- NPI 1720617889
-
- Cardiovascular Disease Physician
- Bridgeport, WV
- NPI 1376595702
-
- Nurse Practitioner
- Clarksburg, WV
- NPI 1093791840
-
- Physician Assistant
- Bridgeport, WV
- NPI 1588912257
-
- Medical Physician Assistant
- Bridgeport, WV
- NPI 1235284886
-
- Interventional Cardiology Physician
- Bluefield, WV
- NPI 1427268911
Cardiovascular Disease
-
- Physician Assistant
- Raleigh, NC
- NPI 1588947097
-
- Interventional Cardiology Physician
- Bowling Green, KY
- NPI 1487826814
-
- Interventional Cardiology Physician
- Lanham, MD
- NPI 1588768741
Cardiovascular Disease
-
- Interventional Cardiology Physician
- Tampa, FL
- NPI 1912913971
Cardiovascular Disease
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430784000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1595980800000",
"number": "1750768149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "527 MEDICAL PARK DR",
"address_2": "STE 306-A",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "263309008",
"telephone_number": "304-933-3830",
"fax_number": "304-933-3837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "527 MEDICAL PARK DR",
"address_2": "STE 306-A",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "263309008",
"telephone_number": "304-933-3830",
"fax_number": "304-933-3837"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLARKSBURG CARDIOVASCULAR PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-05-05",
"last_updated": "2020-07-29",
"certification_date": "2020-07-29",
"status": "A",
"authorized_official_last_name": "REDDY",
"authorized_official_first_name": "SATHYANARAYAN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "304-933-3830",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bridgeport, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.