NPIMap

Organization Active NPI

Capital Regional Heart Associates, LLC

  • Cardiovascular Disease Physician
  • Tallahassee, FL
National Provider Identifier
1992043509
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CAPITAL REGIONAL HEART ASSOCIATES, LLC
Practice address
2631 Centennial Blvd
Suite 200
Tallahassee, FL 32308-0588
Phone
(850) 656-7265
NPI assigned
Jan 17, 2013
Last updated
Jan 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Authorized official

Name
Mickey Pickler
Title
Authorized Official
Phone
(850) 523-2117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

2631 Centennial Blvd
Suite 200
Tallahassee, FL 32308-0588

Mailing address

2631 Centennial Blvd
Suite 200
Tallahassee, FL 32308-0588
Phone (850) 656-7265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130726000327 FL Part B Supplier - Clinic/Group Practice 1850532292 Receives reassigned benefits from 11 practitioners
Practice locations: Tallahassee, FL; Niceville, FL; Quincy, FL; Perry, FL; Panama City, FL; Crawfordville, FL

National Provider Directory

National Provider Directory

Locations

2382 Crawfordville Hwy
Ste D
Crawfordville, FL 32327
Phone (850) 877-0320

2932 Crawfordville Hwy
Ste D
Crawfordville, FL 32327
Phone (850) 656-7265

803 W Main St
Ste D
Perry, FL 32347
Phone (850) 877-0320

2770 Capital Medical Blvd
Ste 109
Tallahassee, FL 32308
Phone (850) 877-0320

4449 Meandering Way
Tallahassee, FL 32308
Phone (850) 201-0956

602 Victoria Pl
Thomasville, GA 31792
Phone (229) 226-7177

602 Victoria Pl
Ste D
Thomasville, GA 31792
Phone (850) 877-0320

Practitioners & affiliated clinicians

Practitioners 12

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": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1992043509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2631 CENTENNIAL BLVD",
            "address_2": "SUITE 200",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080588",
            "telephone_number": "850-656-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2631 CENTENNIAL BLVD",
            "address_2": "SUITE 200",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080588",
            "telephone_number": "850-656-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGIONAL HEART ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "850-523-2117"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.