NPIMap

Organization Active NPI

Green River Heart Institute, P.S.C.

  • Interventional Cardiology Physician
  • Owensboro, KY
National Provider Identifier
1982719852
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
GREEN RIVER HEART INSTITUTE, P.S.C.
Practice address
815 E Parrish Ave
Suite 240
Owensboro, KY 42303-3222
Phone
(270) 688-0808
Fax
(270) 683-5806
NPI assigned
Aug 20, 2006
Last updated
Jul 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Dr. Christopher J. Havelda, M.D.NPI 1316051899
Title
President
Phone
(270) 688-0808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0011X Primary

Addresses

Primary practice location

815 E Parrish Ave
Suite 240
Owensboro, KY 42303-3222

Mailing address

815 E Parrish Ave
Suite 240
Owensboro, KY 42303-3222
Phone (270) 688-0808

Other identifiers 3

IdentifierTypeStateIssuer
65935561MedicaidKY
15E1OtherKYANTHEM BCBS
100006330AMedicaidIN

National Provider Directory

National Provider Directory

Locations

811 E Parrish Ave
Owensboro, KY 42303
Phone (270) 684-8611

815 E Parrish Ave
#240
Owensboro, KY 42303
Phone (270) 688-0808

815 E Parrish Ave
Ste 130
Owensboro, KY 42303
Phone (270) 688-0808

815 E Parrish Ave
Ste 240
Owensboro, KY 42303
Phone (270) 688-0808

815 E Parrish Ave
Ste 240A
Owensboro, KY 42303

Practitioners & affiliated clinicians

Practitioners 7

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1982719852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 E PARRISH AVE",
            "address_2": "SUITE 240",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033222",
            "telephone_number": "270-688-0808",
            "fax_number": "270-683-5806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E PARRISH AVE",
            "address_2": "SUITE 240",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033222",
            "telephone_number": "270-688-0808",
            "fax_number": "270-683-5806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN RIVER HEART INSTITUTE, P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "HAVELDA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-688-0808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65935561",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "15E1",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100006330A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.