NPIMap

Organization Active NPI

Cleveland Health Ventures LLC

  • Cardiovascular Disease Physician
  • Shelby, NC
National Provider Identifier
1780987693
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CLEVELAND HEALTH VENTURES LLC
Practice address
111 W. Grover Street
Shelby, NC 28150-3824
Phone
(704) 482-1006
Fax
(704) 484-8855
NPI assigned
Dec 15, 2010
Organization subpart
Yes
Parent organization
CLEVELAND HEALTH VENTURES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Authorized official

Name
Mr. Daniel Wiens
Title
Senior Vice President
Phone
(704) 355-0648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

111 W. Grover Street
Shelby, NC 28150-3824

Mailing address

PO Box 601884
Charlotte, NC 28260-1884
Phone (704) 482-1006

Other identifiers 2

IdentifierTypeStateIssuer
NPB416MedicaidSC
5917581MedicaidNC

Other names 1

  • CHV SHVI Shelby Doing business as

National Provider Directory

National Provider Directory
Part of
Carolinas Hospitalist Group

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1780987693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601884",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601884",
            "telephone_number": "704-482-1006",
            "fax_number": "704-484-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W. GROVER STREET",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503824",
            "telephone_number": "704-482-1006",
            "fax_number": "704-484-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND HEALTH VENTURES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLEVELAND HEALTH VENTURES LLC",
        "enumeration_date": "2010-12-15",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "WIENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-355-0648",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPB416",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5917581",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHV SHVI Shelby",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.