LIFETIME CARDIOVASCULAR, PLC (NPI# 1548652571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548652571 |
| Entity Type | Organization |
| Organization Name | LIFETIME CARDIOVASCULAR, PLC |
| Other Organization Name | LIFETIME HEART AND VASCULAR |
| Practice Address |
1760 E Florence Blvd #200 Casa Grande AZ 85122-4764 |
| Mailing Address |
2487 S Gilbert Rd Ste. 106-486 Gilbert AZ 85295-8899 |
| Practice Telephone | 4806995536 |
| Practice Fax Number | 4806999283 |
| Mailing Telephone | 4806995536 |
| Mailing Fax Number | 4806999283 |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2015-02-27 |
| Authorized Official Name | GAUTAM KEDIA (PHYSICIAN) |
| Authorized Official Telephone | 4806995536 |
| Authorized Official Credential | M D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 872220 | 05 |
| Other Name | Type Code |
|---|---|
| Lifetime Heart and Vascular | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114324837 | Lifetime Cardiovascular, Plc | Internal Medicine | 3185 N Windsong Dr, Prescott Valley, AZ 86314-2240 | 2014-11-24 |
| 1689071391 | Lifetime Cardiovascular, Plc | Internal Medicine | 287 E Hunt Hwy, Ste 105, San Tan Valley, AZ 85143-5095 | 2014-11-24 |
| Street Address |
1760 E FLORENCE BLVD #200 |
| City | CASA GRANDE |
| State | AZ |
| Zip Code | 85122-4764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750384822 | Surgical Specialties of Casa Grande | Clinic/Center | 1760 E Florence Blvd, Bldg 2, Casa Grande, AZ 85222-4776 | 2005-05-23 |
| 1871751347 | Southwest Physical Therapy and Rehab LLC | Physical Therapist | 1760 E Florence Blvd, Suite #150, Casa Grande, AZ 85222-4764 | 2008-05-30 |
| 1841338977 | Kirti Minesh Patel | Physical Therapist | 1760 E Florence Blvd, Suite #150, Casa Grande, AZ 85222-4764 | 2007-02-01 |
| 1568508679 | Arizona Rehabilitation Associates, Ltd | Clinic/Center | 1760 E Florence Blvd, Suite 150, Casa Grande, AZ 85222-4764 | 2007-01-29 |
| 1881783835 | Casa Grande Pediatrics | Pediatrics | 1760 E Florence Blvd, Ste 220, Casa Grande, AZ 85222-4764 | 2006-10-11 |
| 1356442289 | Allergy Asthma Associates PC | Allergy & Immunology | 1760 E Florence Blvd, Suite 200, Casa Grande, AZ 85222-4764 | 2006-09-25 |
| 1417066788 | Advanced Orthopaedics and Sports Medicine, PC | Orthopaedic Surgery | 1760 E Florence Blvd, Suite 120, Casa Grande, AZ 85122-4764 | 2006-08-30 |
| 1205945482 | Bryan K. Matanky | Orthopaedic Surgery | 1760 E Florence Blvd, Suite 120, Casa Grande, AZ 85222-4764 | 2006-08-30 |
| 1346275534 | Aniceto C Gonda X | Family Medicine | 1760 E Florence Blvd, Ste 260, Casa Grande, AZ 85222 | 2006-07-12 |
| 1679569651 | Edward Kelly | Podiatrist | 1760 E Florence Blvd, Suite 160, Casa Grande, AZ 85222-4764 | 2005-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043857097 | Karen M Garcia | Registered Nurse | 2631 N Brown Avenue, Casa Grande, AZ 85122 | 2019-12-09 |
| 1063060291 | Martha Bollin | Registered Nurse | 2631 N. Brown Ave., Casa Grande, AZ 85122 | 2019-08-30 |
| 1841846920 | Banner Imaging Services LLC | Radiology | 1828 E. Florence Blvd Bldg B Ste 118 & 128, Suite 118 and 128, Casa Grande, AZ 85122 | 2019-08-14 |
| 1629532692 | Kirk Lee Mackley | Physical Therapist | Vibrant Care, 1355 E Florence Blvd #137, Casa Grande, AZ 85122 | 2019-01-24 |
| 1205307436 | Natalie T Trujillo | Physician Assistant | 301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ 85122 | 2018-12-16 |
| 1710455860 | Community Intervention Associates, Inc | Clinic/Center | 1667 N. Trekell Rd, Suite 101 & 102, Casa Grande, AZ 85122 | 2018-11-07 |
| 1245728302 | Jenkins Chiropractic LLC | Chiropractor | 1891 N Trekell Rd Ste 2, Casa Grande, AZ 85122 | 2018-04-24 |
| 1497242408 | Kelly Winnett | Naturopath | 1415 N Trekell Rd Ste 102, Casa Grande, AZ 85122 | 2018-04-16 |
| 1851895783 | Michael Brubaker Counseling | Community/Behavioral Health | 1927 N. Trekell Rd, Ste D, Casa Grande, AZ 85122 | 2018-03-23 |
| 1770095317 | Walmart Stores Inc. | Pharmacy | 1741 E. Florence Blvd, Casa Grande, AZ 85122 | 2017-11-03 |
| Find all providers in zip 85122 | ||||
| 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 |
|---|---|---|---|---|
| 1346234564 | John R Tretter | Internal Medicine | 803 N Salk Dr, Buildings A&b, Casa Grande, AZ 85122-5447 | 2005-09-02 |
| 1366766909 | Premier Cardiovascular Center, Plc | Internal Medicine | 803 N Salk Dr, Casa Grande, AZ 85122-5447 | 2010-03-25 |
| 1174791636 | Romas Joseph Kirvaitis | Internal Medicine | 803 N Salk Dr, Building A, Casa Grande, AZ 85122-5447 | 2008-02-18 |
| 1083648158 | William M Jaffe | Internal Medicine | 1890 E Florence Blvd, Suite 1, Casa Grande, AZ 85122-5642 | 2006-07-11 |
| 1265410641 | James Liguori | Internal Medicine | 803 N Salk Dr, Casa Grande, AZ 85222-5447 | 2006-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528673092 | Cai Ncp East Mesa Jv LLC | Internal Medicine | 10238 E Hampton Ave Ste 201, Mesa, AZ 85209-3318 | 2020-09-11 |
| 1073131561 | Ponderosa Heart House Call | Internal Medicine | 115 S Alto St Ste 3, Prescott, AZ 86303-3603 | 2020-07-10 |
| 1710504667 | Honorhealth Ambulatory | Internal Medicine | 20201 N Scottsdale Healthcare Dr Ste 200, Scottsdale, AZ 85255-4137 | 2020-06-26 |
| 1174149132 | Honorhealth Ambulatory | Internal Medicine | 9250 W Thomas Rd Ste 300, Phoenix, AZ 85037-3384 | 2020-06-24 |
| 1427523471 | Dr. David Wilcoxson and Associates, LLC | Internal Medicine | 6641 E Baywood Ave Ste B3, Mesa, AZ 85206-1723 | 2018-10-05 |
| 1407343841 | Imran Ata Md Pllc | Internal Medicine | 3925 E Fort Lowell Rd Ste 105, Tucson, AZ 85712 | 2018-04-20 |
| 1245733716 | Argento Medical Group LLC | Internal Medicine | 8410 W Thomas Rd Ste 120, Phoenix, AZ 85037-3356 | 2018-03-12 |
| 1508235730 | Joseph Parraz | Internal Medicine | 14340 S Durango Rd # 4, Arizona City, AZ 85123-8719 | 2015-09-17 |
| 1265809628 | Scottsdale Heart & Vascular Associates LLC | Internal Medicine | 4040 E Larkspur Dr, Phoenix, AZ 85032-7420 | 2015-09-01 |
| 1326438276 | Healthfinity, Pllc | Internal Medicine | 6316 W Union Hills Dr Ste 210, Glendale, AZ 85308-1001 | 2015-01-30 |
| Find all providers with the same taxonomy | ||||
| City | CASA GRANDE |
| Zip Code | 85122 |
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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.