Southeastern Heart & Vascular Center PA

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

SOUTHEASTERN HEART & VASCULAR CENTER PA

Practice address

1816 Richardson Dr
Reidsville, NC 27320-5434

Phone

(336) 342-4446

Fax

(336) 342-7747

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Todd Pittman

Title

Executive Director

Phone

(336) 273-7900

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1922193705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 RICHARDSON DR",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205434",
            "telephone_number": "336-342-4446",
            "fax_number": "336-342-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 RICHARDSON DR",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205434",
            "telephone_number": "336-342-4446",
            "fax_number": "336-342-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN HEART & VASCULAR CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "PITTMAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-273-7900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "0129F",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790129F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanea Lauren Smith, LMFTA
• Amanda Kaye Snyder, PHARMD
• Sara R Snyder, DPT
• Demissie H Solomon
• Jessica Marie Southard
• Southern Assisted Living, LLC.
• Brian Avery Spiker, COTA/L
• Tommie W Stanley Jr., PTA
• Laura Wrenn Steele, LMBT
• Cailee Elise Stein, CF-SLP

• Cardiovascular Disease Physician in Reidsville, NC
• Providers in Reidsville, NC by specialty
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.