Cardiac Thoracic & Endovascular Therapies, S.C.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

Legal business name

CARDIAC THORACIC & ENDOVASCULAR THERAPIES, S.C.

Practice address

2420 W Nebraska Ave
Peoria, IL 61604-3112

Phone

(309) 680-5000

Fax

(309) 680-1002

NPI assigned

Jul 31, 2006

Last updated

Jan 30, 2015By 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

Dr. James Bertram Williams, MDNPI 1265433882

Title

Owner/President

Phone

(309) 680-8666

Specialties & licenses 2

Addresses

Other identifiers 4

Locations

Practitioners 3

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.

• James Bertram Williams, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Peoria, IL
  • NPI 1265433882
  Authorized official Same address or phone
• Andrew Daryl Mullins, D.O.

  • Vascular & Interventional Radiology Physician
  • Cape Girardeau, MO
  • NPI 1861493603
  NPD
• Eric J Dippel, M.D.

  • Interventional Cardiology Physician
  • Davenport, IA
  • NPI 1083693949
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1962417485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 W NEBRASKA AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043112",
            "telephone_number": "309-680-5000",
            "fax_number": "309-680-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 W NEBRASKA AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043112",
            "telephone_number": "309-680-5000",
            "fax_number": "309-680-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIAC THORACIC & ENDOVASCULAR THERAPIES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "BERTRAM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "309-680-8666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETIRED RAILROAD MEDICARE",
            "identifier": "P00059260",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NO",
            "identifier": "7232062",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETIRED RAILROAD MEDICARE",
            "identifier": "DS6728",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099138",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candice R Hogden (Christus Light Counseling)
• Rodolfo Luciano Cantu Jr., A.T.C.,L
• Susan M Canty, PA-C
• Elizabeth Joanna Caraballo Torrealba
• Cardiac Consultants SC
• Cardinal Medical Group, LTD.
• Cardiosom, LLC (CardioSom of Peoria)
• Care Planning Institute, Inc
• Care Solutions Home Services LLC
• Christina Lucia Rosa Carfagnini, MD

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Illinois

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