STATELINE HEART AND VASCULAR HEALTH, INC (NPI# 1306361803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306361803 |
| Entity Type | Organization |
| Organization Name | STATELINE HEART AND VASCULAR HEALTH, INC |
| Practice Address |
312 Fairy Street Ext Ste 101 Martinsville VA 24112-1912 |
| Mailing Address |
20 Hunt Country Farms Rd Martinsville VA 24112-6622 |
| Practice Telephone | (757) 813-6493 |
| Mailing Telephone | 7578136493 |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2017-08-31 |
| Authorized Official Name | DR. DEEPAK DILIP BANERJEE (PRESIDENT) |
| Authorized Official Telephone | 7578136493 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
0101230554 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
312 FAIRY STREET EXT STE 101 |
| City | MARTINSVILLE |
| State | VA |
| Zip Code | 24112-1912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205327038 | Martinsville Transit, LLC | Taxi | 807 Barrows Mill Rd Apt E, Martinsville, VA 24112 | 2018-05-29 |
| 1699279422 | Terry Michelle Hamdy | Nurse Practitioner | 110 Commonwealth Blvd, Martinsville, VA 24112 | 2018-03-19 |
| 1780184523 | Susan Fullerton | Speech-Language Pathologist | 288 Lancer Lane, Martinsville, VA 24112 | 2018-02-19 |
| 1164920062 | Aesthetic & Family Dental of Martinsville PC | Dentist | 5 Dudley Street, Martinsville, VA 24112 | 2018-01-25 |
| 1124537410 | Hamdy Medical Center, PC | Clinic/Center | 110 W Commonwealth Blvd, Martinsville, VA 24112 | 2017-09-29 |
| 1588180483 | Olton Swanson | Driver | 1440 Rivermount Heights, Martinsville, VA 24112 | 2017-08-22 |
| 1639610686 | Stephanie Hairston | Non-emergency Medical Transport (VAN) | 912 Brookdale St, Ste 1, Martinsville, VA 24112 | 2017-03-10 |
| 1194182790 | Jns Home Healthcare Services | In Home Supportive Care | 708 Berkshire Place, Martinsville, VA 24112 | 2016-01-27 |
| 1033506654 | Caring Hearts Counseling LLC | Community/Behavioral Health | 624 East Church, Suite B, Martinsville, VA 24112 | 2015-04-21 |
| 1073915559 | Shirley Jackson | Occupational Therapy Assistant | 170 Village Court, Martinsville, VA 24112 | 2014-09-16 |
| Find all providers in zip 24112 | ||||
| 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 |
|---|---|---|---|---|
| 1619215852 | Sarnelle Diagnostic LLC | Internal Medicine | 15 Davis Ct, Martinsville, NJ 08836-2316 | 2013-01-23 |
| 1518291715 | Union Associated Physicians Clinic, LLC | Internal Medicine | 890 Ridgelawn Road, Martinsville, IL 62442-0399 | 2009-09-22 |
| 1275692717 | Jack Allan Painter | Internal Medicine | 26 Broad St, Martinsville, VA 24112-2802 | 2006-12-08 |
| 1437117579 | Deepak D. Banerjee | Internal Medicine | 319 Hospital Drive, Suite 102, Martinsville, VA 24112 | 2006-05-01 |
| 1346240785 | Mark Lebenthal | Internal Medicine | 1001 Laurel Trl, Martinsville, NJ 08836-2212 | 2005-07-28 |
| 1770967770 | Mark Lebenthal Md LLC | Internal Medicine | 1001 Laurel Trl, Martinsville, NJ 08836-2212 | 2015-07-20 |
| 1841452018 | Heart of Virginia PC | Internal Medicine | 26 Broad St, Martinsville, VA 24112-2802 | 2008-06-30 |
| 1356501977 | Indiana Heart Hospital LLC | Internal Medicine | 2209 John R Wooden Dr, Martinsville, IN 46151-1840 | 2008-06-17 |
| 1548477664 | Indiana Heart Physicians, Inc. | Internal Medicine | 2200 John R Wooden Dr, Suite 100, Martinsville, IN 46151-1863 | 2007-05-17 |
| 1750334124 | Indiana Heart Associates PC | Internal Medicine | 2209 John R Wooden Dr, Martinsville, IN 46151-1840 | 2006-05-18 |
| Find all providers in MARTINSVILLE | ||||
| City | MARTINSVILLE |
| Zip Code | 24112 |
Please comment or provide details below to improve the information on STATELINE HEART AND VASCULAR HEALTH, INC.
| 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.