LIBERTY CARDIOVASCULAR SPECIALISTS (NPI# 1013146448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013146448 |
| Entity Type | Organization |
| Organization Name | LIBERTY CARDIOVASCULAR SPECIALISTS |
| Practice Address |
2521 Glenn Hendren Dr Suite 306 Liberty MO 64068-3388 |
| Practice Telephone | 8164075430 |
| Practice Fax Number | 8164075435 |
| Mailing Telephone | 8164075430 |
| Mailing Fax Number | 8164075435 |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2009-11-05 |
| Authorized Official Name | MR. JOSEPH W CROSSETT (ADMINISTRATOR) |
| Authorized Official Telephone | 8167817200 |
| Is Organization Subpart | Y |
| Parent Organization Name | NEW LIBERTY HOSPITAL DISTRICT OF CLAY COUNTY MISSOURI |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Street Address |
2521 GLENN HENDREN DR SUITE 306 |
| City | LIBERTY |
| State | MO |
| Zip Code | 64068-3388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740283753 | Thomas F Jones | Specialist | 2521 Glenn Hendren Dr, Ste 408, Liberty, MO 64068-3388 | 2005-05-23 |
| 1548719750 | Sarah Love | Nurse Practitioner | 2521 Glenn Hendren Dr, Suite 306, Liberty, MO 64068-3388 | 2016-09-28 |
| 1750838421 | Crowntown General Surgery, PC | Surgery | 2521 Glenn Hendren Dr, Suite 410, Liberty, MO 64068-3388 | 2016-09-09 |
| 1740609460 | Katie Brewer | Audiologist | 2521 Glenn Hendren Dr, Suite 104, Liberty, MO 64068-3388 | 2014-04-09 |
| 1750633327 | New Liberty Hospital Corporation | Internal Medicine | 2521 Glenn Hendren Dr, Suite 306, Liberty, MO 64068-3388 | 2012-10-08 |
| 1023369212 | Abigail Boethin | Physician Assistant | 2521 Glenn Hendren Dr, Ste 306, Liberty, MO 64068-3388 | 2012-09-27 |
| 1215288733 | New Liberty Hospital Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2521 Glenn Hendren Dr, Suite 308, Liberty, MO 64068-3388 | 2012-09-24 |
| 1093940157 | Kirstie Schneider Van Ry | Surgery | 2521 Glenn Hendren Dr, Ste 108, Liberty, MO 64068-3388 | 2009-05-19 |
| 1457597205 | Carlene Marie Breen | Nurse Practitioner | 2521 Glenn Hendren Dr, Ste 306, Liberty, MO 64068-3388 | 2008-12-29 |
| 1740444611 | Sheryl Ann Nespory | Registered Nurse | 2521 Glenn Hendren Dr, Suite 410, Liberty, MO 64068-3388 | 2008-07-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437258 | Midwestern Medical Consultants LLC | Assisted Living Facility | 227 W. Franklin St, Liberty, MO 64068 | 2019-09-26 |
| 1063935062 | Jennifer Nichole Gibson | Nurse Practitioner | Liberty Hospital 2525 Glen Hendren Dr, Liberty, MO 64068 | 2017-07-21 |
| 1598288755 | Lhlc Operations, LLC | Skilled Nursing Facility | 2609 Glenn Hendren Dr Ste G100, Liberty, MO 64068 | 2017-07-19 |
| 1023438371 | Sarah E Ehlers | Social Worker | 1170 W. Kansas Ave, Bldg 10, Liberty, MO 64068 | 2014-04-24 |
| 1629498563 | Kelli Hedgpeth | Physical Therapy Assistant | 3980 South Jackson Dr, Independence, MO 64068 | 2014-04-18 |
| 1639593965 | Klein Dental Group LLC | Clinic/Center | 12 Westwoods Dr, Liberty, MO 64068 | 2014-02-06 |
| 1124457239 | Sarah Ehlers, Lcsw LLC | Social Worker | 1170 W Kansas Ave, Bldg 10, Liberty, MO 64068 | 2013-11-08 |
| 1134561558 | Holly Hemphill | Marriage & Family Therapist | 117 N. Water Street, Liberty, MO 64068 | 2013-07-26 |
| 1093157133 | Tina Wilma Sanborn | Marriage & Family Therapist | 1170 W. Kansas St., Liberty, MO 64068 | 2013-07-17 |
| 1609215441 | Timothy Adam Lynch | Marriage & Family Therapist | 1170 West Kansas Ave., Liberty, MO 64068 | 2013-06-14 |
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| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750633327 | New Liberty Hospital Corporation | Internal Medicine | 2521 Glenn Hendren Dr, Suite 306, Liberty, MO 64068-3388 | 2012-10-08 |
| 1619264256 | Calvin Geoffrey Madrigal | Internal Medicine | 2521 Glenn Hendren Dr Ste 306, Liberty, MO 64068 | 2011-07-04 |
| 1326208406 | Martina Milcevic | Internal Medicine | 2521 Glenn Hendren Dr, Ste 306, Liberty, MO 64068-3388 | 2008-06-12 |
| 1609079938 | Dwarakraj Soundarraj | Internal Medicine | 2521 Glenn Hendren Dr, Suite 306, Liberty, MO 64068-3388 | 2007-06-06 |
| 1487790267 | Advanced Cardiovascular Specialists I,llc | Internal Medicine | 1530 N Church Rd, Liberty, MO 64068-7129 | 2007-01-29 |
| 1922020395 | Dak R Burnett | Internal Medicine | 1530 N Church Rd, Liberty, MO 64068-7129 | 2006-07-24 |
| 1528080686 | Gary D Beauchamp | Internal Medicine | 1530 N Church Rd, Liberty, MO 64068-7129 | 2006-07-24 |
| 1083636740 | John R Muccia | Internal Medicine | 15 John St, Liberty, NY 12754 | 2006-07-24 |
| 1326089285 | Tapas Ghose | Internal Medicine | 2521 Glenn Hendren Dr Ste 306, Liberty, MO 64068-3388 | 2006-06-09 |
| 1790769685 | Arnold Jay Pollak | Internal Medicine | 2521 Glenn Hendren Dr, Suite 306, Liberty, MO 64068-3388 | 2005-12-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.