CARDIAC RENAL & VASCULAR ASSOCIATES PC (NPI# 1649555467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649555467 |
| Entity Type | Organization |
| Organization Name | CARDIAC RENAL & VASCULAR ASSOCIATES PC |
| Practice Address |
5240 Robinson Road Ext Jackson MS 39204-4276 |
| Practice Telephone | 6013980904 |
| Practice Fax Number | 6013982149 |
| Mailing Telephone | 6013980904 |
| Mailing Fax Number | 6013982149 |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2013-12-11 |
| Authorized Official Name | DR. OLUROTIMI JOHN BADERO (REGISTERED AGENT) |
| Authorized Official Telephone | 6017505736 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
21527 | MS | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
21527 | MS | Allopathic & Osteopathic Physicians |
| Street Address |
5240 ROBINSON ROAD EXT |
| City | JACKSON |
| State | MS |
| Zip Code | 39204-4276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639797442 | Walk By Faith Not By Sight Homecare | Student in an Organized Health Care Education/Training Program | 2310 Us-80 West, Suite F 1154, Jackson, MS 39204 | 2020-07-08 |
| 1427593888 | Care First Home Care Agency, Inc | In Home Supportive Care | 931 Hwy 80 Suite 2 B-9, Jackson, MS 39204 | 2016-12-21 |
| 1134678808 | Yolonda Kinzie | Registered Nurse | 1134 Winter St., Jackson, MS 39204 | 2016-09-23 |
| 1578983938 | Seaneather Arline Mcgill | Nurse's Aide | 2024 Shady Lane Dr, Jackson, MS 39204 | 2014-04-23 |
| 1942591128 | Real Solutilons, LLC | Exclusive Provider Organization | 831 Hwy 80 W., Jackson, MS 39204 | 2011-04-22 |
| 1548405236 | Visions Physical Therapy | Specialist/Technologist | 4700 Robinson Rd, Jackson, MS 39204 | 2008-12-09 |
| 1588759393 | Donald H Butts | Specialist | 1920 Chadwick Drive, Suite 109, Jackson, MS 39204 | 2006-10-04 |
| 1003907460 | Patrick E Weldon | Psychiatry & Neurology | 1860 Chadwick Drive, Suite 258, Jackson, MS 39204 | 2006-09-28 |
| 1922117662 | Elgin Kenneth Walley | Dentist | 2174 Henry Hill Drive, Jackson, MS 39204 | 2006-08-29 |
| 1376555045 | Linda Nell Hunter | Nurse Practitioner | 1860 Chadwick Dr Ste 150a, Jackson, MS 39204 | 2006-08-12 |
| Find all providers in zip 39204 | ||||
| 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 |
|---|---|---|---|---|
| 1467494070 | Apex Cardiology PC | Internal Medicine | 327 Summar Dr, Jackson, TN 38301-3930 | 2006-06-11 |
| 1053970624 | Jackson Cardiology Consultants Pllc | Internal Medicine | 205 Page Ave, Jackson, MI 49201-2462 | 2019-06-07 |
| 1053873133 | Cms Care of Ms, LLC | Internal Medicine | 460 Briarwood Dr Ste 400, Jackson, MS 39206-3062 | 2019-04-05 |
| 1497292361 | W.a. Foote Memorial Hospital, Inc | Internal Medicine | 205 N. East Ave, Jackson, MI 49201 | 2017-01-30 |
| 1841602257 | Mississippi Vascular Center, Pllc | Internal Medicine | 571 E Beasley Rd, Jackson, MS 39206-3042 | 2014-05-20 |
| 1629207170 | Shawn Sanders | Internal Medicine | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2009-07-06 |
| 1558523464 | Montoya Taylor | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2008-07-01 |
| 1679506547 | Tommy L. Miller IIi | Internal Medicine | 48 Medical Center Dr, Jackson, TN 38301-3947 | 2006-07-07 |
| 1811939424 | Henry K S Lui | Internal Medicine | 327 Summar Dr, Jackson, TN 38301-3930 | 2006-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134761786 | Cardiovascular Health Center Pllc | Internal Medicine | 4211 Hospital St Ste 202, Pascagoula, MS 39581-5310 | 2019-10-16 |
| 1497224174 | Fusion Vascular, LLC | Internal Medicine | 800 Pearman Ave, Cleveland, MS 38732-3502 | 2018-11-25 |
| 1679730329 | Foluso A Fakorede | Internal Medicine | 800 N Pearman Ave, Cleveland, MS 38732-3502 | 2008-05-20 |
| 1073617775 | Jimmy Darrell Sneed | Internal Medicine | 391 Southcrest Cir Ste 200, Southaven, MS 38671-6729 | 2006-09-12 |
| 1245214196 | Hemraj R. Makwana | Internal Medicine | 520 Willowbrook Rd, Columbus, MS 39705-2015 | 2005-12-05 |
| 1720087257 | Joon K Chang | Internal Medicine | 255 Baptist Blvd, Ste. 401, Columbus, MS 39705-2011 | 2005-07-18 |
| 1154989689 | King and Associates Cardiology Pllc | Internal Medicine | 2323 5th St N, Columbus, MS 39705-2213 | 2019-05-30 |
| 1760975692 | Fusion Vascular Center, LLC | Internal Medicine | 800 Pearman Ave, Cleveland, MS 38732 | 2018-06-14 |
| 1356712848 | Cardiovascular Solutions of Central Ms Pa | Internal Medicine | 800 N Pearman Ave, Cleveland, MS 38732-3502 | 2015-10-09 |
| 1427439348 | Corinth Cardiovascular Care, Pllc | Internal Medicine | 2427 Proper St, Corinth, MS 38834-5394 | 2015-06-16 |
| Find all providers with the same taxonomy | ||||
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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.