NPIMap

Organization Active NPI

Cardiovascular Specialists PSC

  • Cardiovascular Disease Physician
  • Louisville, KY
National Provider Identifier
1871512160
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOVASCULAR SPECIALISTS PSC
Practice address
100 Mallard Creek Rd
Suite 150
Louisville, KY 40207-5138
Phone
(502) 589-7907
Fax
(502) 589-1319
NPI assigned
Jul 18, 2006
Last updated
Jun 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Authorized official

Name
Christodulos S Stavens, MDNPI 1659457232
Title
President
Phone
(502) 589-7907

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

100 Mallard Creek Rd
Suite 150
Louisville, KY 40207-5138

Mailing address

100 Mallard Creek Rd
Suite 150
Louisville, KY 40207-5138
Phone (502) 589-7907

Other identifiers 5

IdentifierTypeStateIssuer
CI7476OtherINRAILROAD MEDICARE
CI6702OtherKYRAILROAD MEDICARE
65931560MedicaidKY
200208100MedicaidIN
1093228OtherKYPASSPORT HEALTH PLAN

National Provider Directory

National Provider Directory

Locations

313 Federal Dr NW
Ste 150
Corydon, IN 47112
Phone (502) 589-7907

2580 Michigan Rd
Ste 3
Madison, IN 47250
Phone (812) 265-4193

1964 State St
#310
New Albany, IN 47150
Phone (812) 542-1530

320 High St
Barbourville, KY 40906
Phone (606) 546-2600

1707 Falls Hwy
#1
Corbin, KY 40701
Phone (606) 528-0874

1406 W 5th St
#3
London, KY 40741
Phone (606) 864-5936

250 E Liberty St
Ste 1001
Louisville, KY 40202
Phone (502) 585-7507

3900 Kresge Way
#35
Louisville, KY 40207
Phone (502) 259-4770

1 S Creek Dr
Ste 1002
Monticello, KY 42633
Phone (606) 348-3365

720 Hospital Dr
Ste 110
Shelbyville, KY 40065
Phone (502) 633-5374

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3402/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1871512160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD",
            "address_2": "SUITE 150",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075138",
            "telephone_number": "502-589-7907",
            "fax_number": "502-589-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD",
            "address_2": "SUITE 150",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075138",
            "telephone_number": "502-589-7907",
            "fax_number": "502-589-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR SPECIALISTS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "STAVENS",
        "authorized_official_first_name": "CHRISTODULOS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-589-7907",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI7476",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI6702",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65931560",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200208100",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "1093228",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.