Havasu Lung and Sleep Disorders Center LLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

42565 Issued in AZ

Legal business name

HAVASU LUNG AND SLEEP DISORDERS CENTER LLC

Practice address

1830 Mesquite Ave
Ste C
Lake Havasu City, AZ 86403-5885

Phone

(928) 855-6966

Fax

(928) 855-6974

NPI assigned

Nov 16, 2009

Last updated

Oct 25, 2010By 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

Heidi A Berdin, M.D.NPI 1659368751

Title

Owner/Member

Phone

(928) 855-6966

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DEEIAA

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.

• Heidi A Berdin, MD

  • Pulmonary Disease Physician
  • Lake Havasu City, AZ
  • NPI 1659368751
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287964800000",
    "number": "1841527645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4559",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864054559",
            "telephone_number": "928-855-6966",
            "fax_number": "928-855-6974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 MESQUITE AVE",
            "address_2": "STE C",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035885",
            "telephone_number": "928-855-6966",
            "fax_number": "928-855-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVASU LUNG AND SLEEP DISORDERS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-16",
        "last_updated": "2010-10-25",
        "status": "A",
        "authorized_official_last_name": "BERDIN",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "928-855-6966",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AZ",
            "license": "42565",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "42565",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "AZ",
            "license": "42565",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION NUMBER",
            "identifier": "L-1566579-8",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "480404",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Havasu Emergency Physicians, PC
• Havasu Foot & Ankle Center
• Havasu Foot & Ankle Center
• Havasu Health Care Pharm
• Havasu House Call PLLC
• Havasu Medical Care
• Havasu Medical Supply Inc.
• Havasu Neurological Center PLLC
• Havasu Nursing Center 2 Inc (Havasu Nursing Center)
• Havasu Physical Therapy (Donna G Jones D/B/A Havasu Physical Therapy)

• Pulmonary Disease Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Pulmonary Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.