NPIMap

Organization Active NPI

Clarksburg Cardiology Consultants

  • Cardiovascular Disease Physician
  • Bridgeport, WV
National Provider Identifier
1871531897
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
044134 Issued in WV
Legal business name
CLARKSBURG CARDIOLOGY CONSULTANTS
Practice address
527 Medical Park Drive
Ste 306
Bridgeport, WV 26330-9008
Phone
(304) 933-3830
Fax
(304) 933-3837
NPI assigned
Jun 3, 2006
Last updated
Jan 31, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Authorized official

Name
S.M. Reddy, M.D.
Title
Partner
Phone
(304) 933-3830

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU
Cardiovascular Disease Physician 207RC0000X 044134 WV Primary

Addresses

Primary practice location

527 Medical Park Drive
Ste 306
Bridgeport, WV 26330-9008

Mailing address

527 Medical Park Drive
Ste 306
Bridgeport, WV 26330-9008
Phone (304) 933-3830

Other identifiers 5

IdentifierTypeStateIssuer
1327565OtherWVUWMA GROUP
000465033MedicaidWV
1327565OtherWVUMW GROUP
000465033OtherWVBCBS GROUP
0011726000MedicaidWV

National Provider Directory

National Provider Directory

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": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391126400000",
    "number": "1871531897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DRIVE",
            "address_2": "STE 306",
            "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 DRIVE",
            "address_2": "STE 306",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309008",
            "telephone_number": "304-933-3830",
            "fax_number": "304-933-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSBURG CARDIOLOGY CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2014-01-31",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "S.M.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "304-933-3830",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WV",
            "license": "044134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UWMA GROUP",
            "identifier": "1327565",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000465033",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMW GROUP",
            "identifier": "1327565",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "000465033",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011726000",
            "state": "WV"
        }
    ],
    "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 Jan 31, 2014; 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.