CENTRIC OUTPATIENT CATH LAB LLC


Address: 2103 Silva Ln, Moberly, MO 65270-3660
Phone: 6606160022

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RI0011X Internal Medicine
Specialization: Interventional Cardiology
2002015751 MO Allopathic & Osteopathic Physicians

Office Location

Street Address 2103 SILVA LN
City MOBERLY
State MO
Zip Code 65270-3660

Providers in the same location

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

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NPI Name Taxonomy Address Enumeration
1538628052 Thomas Johnston Physical Therapist Thrive Physical Therapy, LLC, 417 E Urbandale Drive, Moberly, MO 65270 2019-03-14
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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
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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
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Taxonomy Information

Taxonomy Code 207RI0011X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Interventional Cardiology

Taxonomy Definition

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)

Providers in the same taxonomy and state

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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Competitor

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City MOBERLY
Zip Code 65270

Improve Information

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Dataset Information

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.

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