LIFETIME CARDIOVASCULAR, PLC (NPI# 1689071391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689071391 |
| Entity Type | Organization |
| Organization Name | LIFETIME CARDIOVASCULAR, PLC |
| Other Organization Name | LIFETIME HEART AND VASCULAR |
| Practice Address |
287 E Hunt Hwy Ste 105 San Tan Valley AZ 85143-5095 |
| 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 | 2014-11-24 |
| Last Update Date | 2014-11-24 |
| Authorized Official Name | DR. GAUTAM KEDIA (MD) |
| Authorized Official Telephone | 4806995536 |
| 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 |
AZ | 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 |
|---|---|---|---|---|
| 1548652571 | Lifetime Cardiovascular, Plc | Internal Medicine | 1760 E Florence Blvd, #200, Casa Grande, AZ 85122-4764 | 2015-02-27 |
| 1114324837 | Lifetime Cardiovascular, Plc | Internal Medicine | 3185 N Windsong Dr, Prescott Valley, AZ 86314-2240 | 2014-11-24 |
| Street Address |
287 E HUNT HWY STE 105 |
| City | SAN TAN VALLEY |
| State | AZ |
| Zip Code | 85143-5095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962403113 | Arlyn R Mason | Nurse Practitioner | 287 E Hunt Hwy, Suite # 105, San Tan Valley, AZ 85143-5095 | 2005-08-09 |
| 1770951618 | Brooke Ashleigh Allen | Nurse Practitioner | 287 E Hunt Hwy, Suite 105, San Tan Valley, AZ 85143-5095 | 2015-09-09 |
| 1447627856 | Kiara Deem | Nurse Practitioner | 287 E Hunt Hwy, Suite 105, San Tan Valley, AZ 85143-5095 | 2015-09-01 |
| 1821491713 | Riley Hooks | Physician Assistant | 287 E Hunt Hwy, Suite 105, San Tan Valley, AZ 85143-5095 | 2014-10-06 |
| 1477961225 | James Edward Edmond Jr. | Physician Assistant | 287 E Hunt Hwy, Suite 105, San Tan Valley, AZ 85143-5095 | 2014-07-24 |
| 1942559323 | Mario Eleno De Castro Cordero IIi | Nurse Practitioner | 287 E Hunt Hwy, Suite 105, San Tan Valley, AZ 85143-5095 | 2012-08-31 |
| 1659676351 | Crystal Lynn Mcelroy | Nurse Practitioner | 287 E Hunt Hwy, San Tan Valley, AZ 85143-5095 | 2011-01-11 |
| 1255593950 | Michael Rowley | Surgery | 287 E Hunt Hwy, Suite 105, San Tan Valley, AZ 85143-5095 | 2008-06-25 |
| 1972798866 | Cynthia Louise Thomas | Physician Assistant | 287 E Hunt Hwy, Suite 105, San Tan Valley, AZ 85143-5095 | 2007-09-13 |
| 1639211246 | Brian Cafaro | Family Medicine | 287 E Hunt Hwy, Suite 105, San Tan Valley, AZ 85143-5095 | 2007-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619457785 | Shalom Behavioral Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35301 N Belgian Blue Ct, San Tan Valley, AZ 85143 | 2018-08-18 |
| 1336662337 | House of Dignity Assisted Living LLC | Assisted Living Facility | 214 W Danish Red Trl, San Tan Valley, AZ 85143 | 2017-07-21 |
| 1942744081 | Arizona Dental Professionals, PC | Dentist | 545 E Hunt Hwy, San Tan Valley, AZ 85143 | 2016-12-08 |
| 1285000786 | Jared Scott Snyder | Physical Therapy Assistant | 1745 E Hunt Hwy, Suite 103, San Tan Valley, AZ 85143 | 2015-08-19 |
| 1801289236 | Tiffany Battle | Behavioral Analyst | 2626 E. Manuel Road, San Tan Valley, AZ 85143 | 2015-03-10 |
| 1437541091 | Kelly Denise Griffin | Registered Nurse | 35945 N. Gary Rd, Suite 101, San Tan Valley, AZ 85143 | 2015-02-19 |
| 1528496031 | Casey Manzanedo | Licensed Practical Nurse | 35900 E Charbray Dr., San Tan Valley, AZ 85143 | 2013-10-18 |
| 1891136461 | Lisa Kay Scarpa | Home Health Aide | 925 E Canyon Rock Rd, San Tan Valley, AZ 85143 | 2013-07-11 |
| 1790969426 | Emilia Elizabeth Gomez Vieytez | Pediatrics | 22707 S. Ellsworth Rd H 101, Queen Creek, AZ 85143 | 2007-12-17 |
| 1205814621 | Janet F Rinehart | Family Medicine | 30046 N Varnum Rd, San Tan Valley, AZ 85143 | 2006-01-05 |
| Find all providers in zip 85143 | ||||
| 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 |
|---|---|---|---|---|
| 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 | SAN TAN VALLEY |
| Zip Code | 85143 |
Please comment or provide details below to improve the information on LIFETIME CARDIOVASCULAR, PLC.
| 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.