CENTRIC OUTPATIENT CATH LAB LLC (NPI# 1306340997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306340997 |
Entity Type | Organization |
Organization Name | CENTRIC OUTPATIENT CATH LAB LLC |
Practice Address |
2103 Silva Ln Moberly MO 65270-3660 |
Practice Telephone | 6606160022 |
Mailing Telephone | 6606160022 |
Enumeration Date | 2018-03-20 |
Last Update Date | 2018-03-20 |
Authorized Official Name | DR. SANJEEV DHARI RAVIPUDI (OWNER) |
Authorized Official Telephone | 6263946299 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
2002015751 | MO | Allopathic & Osteopathic Physicians |
Street Address |
2103 SILVA LN |
City | MOBERLY |
State | MO |
Zip Code | 65270-3660 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588657811 | Sanjeev Dhari Ravipudi | Internal Medicine | 2103 Silva Ln, Moberly, MO 65270 | 2005-08-23 |
1487158796 | Centric Ambulatory Surgery Center LLC | Clinic/Center | 2103 Silva Ln, Moberly, MO 65270-3660 | 2018-03-21 |
1356845945 | Centric Heart & Vascular LLC | Internal Medicine | 2103 Silva Ln, Moberly, MO 65270-3660 | 2018-03-20 |
1043511447 | Tb Anesthesia Associates | Anesthesiology | 2103 Silva Ln, Moberly, MO 65270-3660 | 2010-11-16 |
1982675856 | Anesthesia Care Providers LLC | Nurse Anesthetist, Certified Registered | 2103 Silva Ln, Moberly, MO 65270-3660 | 2006-01-30 |
1144206665 | Moberly Surgery Center LLC | Clinic/Center | 2103 Silva Ln, Moberly, MO 65270-3660 | 2005-12-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538628052 | Thomas Johnston | Physical Therapist | Thrive Physical Therapy, LLC, 417 E Urbandale Drive, Moberly, MO 65270 | 2019-03-14 |
1245709682 | Sam's Prescription Shop, Inc. | Durable Medical Equipment & Medical Supplies | 300 N. Morley Street, Moberly, MO 65270 | 2018-11-15 |
1639324585 | Trinidad J. Aguilera | General Practice | 5201 South Morley, Moberly, MO 65270 | 2008-11-19 |
1023270170 | Jessica Winn | Internal Medicine | 1513 Union Ave Ste 1500, Moberly, MO 65270 | 2008-06-30 |
1629237383 | Heather Ann Lavalley | Physical Therapy Assistant | 1346 S Morley, Moberly, MO 65270 | 2008-06-06 |
1265602429 | Mckenzie Prescription Center Inc | Hearing Aid Equipment | 643 N Morley St Ste A, Moberly, MO 65270 | 2008-03-04 |
1366624165 | Sharon Kay Steele | Military Hospital | 1510 Highway Jj Lot41, Moberly, MO 65270 | 2007-12-04 |
1932241536 | Christian S Tadrus | Pharmacist | 530 E. 24 Highway, (26-39586), Moberly, MO 65270 | 2007-02-12 |
1588700140 | Heartland Neurology, LLC | Psychiatry & Neurology | 300 N. Morley, Suite H, Moberly, MO 65270 | 2007-01-30 |
1164571519 | John James Oloughlin | Dentist | 1616 N Morely, Ste B, Moberly, MO 65270 | 2007-01-08 |
Find all providers in zip 65270 |
Taxonomy Code | 207RI0011X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Interventional Cardiology |
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275032286 | Cardiac Cin of Kansas City LLC | Internal Medicine | 111 W 10th St Ste 103, Kansas City, MO 64105-1700 | 2018-02-05 |
1437658440 | Cardiac Cin of St Louis LLC | Internal Medicine | 11628 Old Ballas Rd # 346, Saint Louis, MO 63141-7030 | 2018-02-05 |
1629366984 | Jorge Marcelo Ramirez Romero | Internal Medicine | 1402 S. Grand, Fdt 14th Floor, St. Louis, MO 63104 | 2011-07-20 |
1164737490 | Mohan Mallikarjuna Edupuganti | Internal Medicine | 901 Patients First Dr Ste 2500, Washington, MO 63090 | 2010-08-11 |
1285945295 | Byungsoo Ko | Internal Medicine | 100 Mercy Way Ste 320, Joplin, MO 64804-4524 | 2010-06-24 |
1033370358 | Shamail S. Tariq | Internal Medicine | 1071 Airport Rd, Festus, MO 63028-4103 | 2008-06-19 |
1104083351 | Cardiovascular Institute of Jacksonville P A | Internal Medicine | 1406 Ridgetree Trails Dr, Wildwood, MO 63021-5930 | 2008-05-16 |
1053401422 | Gus Theodos | Internal Medicine | 710 S Price Rd, Saint Louis, MO 63124-1867 | 2006-10-13 |
1225134117 | William R Reilly Inc | Internal Medicine | 450 N. New Ballas Rd, Ste 170w, St. Louis, MO 63141-6835 | 2006-09-16 |
1881799336 | Morton R. Rinder | Internal Medicine | 222 S Woods Mill Rd Ste 560, Chesterfield, MO 63017-3625 | 2006-09-13 |
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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.