CENTRUM CARDIOLOGY, LTD (NPI# 1932396157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932396157 |
| Entity Type | Organization |
| Organization Name | CENTRUM CARDIOLOGY, LTD |
| Other Organization Name | RANDOLPH S MARTIN, MD, SC |
| Practice Address |
319 E Madison St Ste 2d Springfield IL 62701-3120 |
| Practice Telephone | 2175460750 |
| Practice Fax Number | 2175460894 |
| Mailing Telephone | (217) 546-0750 |
| Mailing Fax Number | 2175460894 |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2017-07-25 |
| Authorized Official Name | DR. RANDOLPH S. MARTIN (PRESIDENT) |
| Authorized Official Telephone | 2175460750 |
| 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 |
036079474 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | HEALTH ALLIANCE | 008092 | 01 |
| IL | COVENTRY HEATH CARE | 222623 | 01 |
| IL | BLUE CROSS BLUE SHIELD | 08432108 | 01 |
| IL | CIGNA | 9683056002 | 01 |
| IL | RAILROAD MEDICARE | P00140870 | 01 |
| IL | HEALTHLINK, INC | 133621 | 01 |
| IL | 036079474 | 05 | |
| IL | FIRST HEALTH | 823599 | 01 |
| Other Name | Type Code |
|---|---|
| Randolph S Martin, MD, SC | Former Legal Business Name - Organization |
| Street Address |
319 E MADISON ST STE 2D |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62701-3120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687183 | Affinity Patient Coordination LLC | In Home Supportive Care | 217 E Monroe St Ste 102, Springfield, IL 62701 | 2018-07-31 |
| 1427498435 | Donald L Jacoby | Pharmacist | 701 N. First St., Springfield, IL 62701 | 2013-07-05 |
| 1700183480 | Erin Zepp | Dietitian, Registered | 319 E Madison St Ste 1f, Springfield, IL 62701 | 2011-02-16 |
| 1518117159 | Jyoti Assudani | Pediatrics | 301 N 8th Street, Springfield, IL 62701 | 2008-09-19 |
| 1396924148 | Jeanne Lyn Malone | Counselor | 408 South Fifth Street, Springfield, IL 62701 | 2007-10-29 |
| 1942422928 | Nobuharu Harada | Family Medicine | 301 N 8th, Pav-3a158, Springfield, IL 62701 | 2007-05-02 |
| 1427131127 | Radiological Associates of Decatur | Radiology | 319 E Madison Suite J, Springfield Mri & Imaging Center, Springfield, IL 62701 | 2006-10-24 |
| 1669498606 | Independence Holding Co LLC | Pharmacy | 201 North 5th Street, Springfield, IL 62701 | 2006-07-14 |
| 1720070238 | Neil J. Thomas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2005-08-19 |
| 1588187397 | Andrea Nicole Bloodworth | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2017-07-24 |
| Find all providers in zip 62701 | ||||
| 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 |
|---|---|---|---|---|
| 1366905523 | Premier Cardiac and Vascular LLC | Internal Medicine | 5514 Alma Ln Ste 200, Springfield, VA 22151-4014 | 2019-04-12 |
| 1760820930 | Shady Henien | Internal Medicine | 800 E Carpenter St # 62, Springfield, IL 62769-1000 | 2013-06-11 |
| 1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
| 1669784781 | Clifford Eugene Schott Jr. | Internal Medicine | 531 W Woodland Ave, Springfield, PA 19064-1646 | 2010-07-06 |
| 1730406760 | Joseph James Marmora | Internal Medicine | 211 Mountain Avenue, Associates In Cardiovascular Disease, Springfield, NJ 07081 | 2010-04-30 |
| 1083858310 | Brian Scott Wasserman | Internal Medicine | 3300 Main St Fl 2, Springfield, MA 01107-1112 | 2009-04-30 |
| 1104085505 | Sujata Holman | Internal Medicine | 2 Medical Center Dr Ste 410, Springfield, MA 01107-1273 | 2008-06-02 |
| 1386858876 | Allen B. Weisse | Internal Medicine | 164 Hillside Ave, Springfield, NJ 07081-2808 | 2007-05-10 |
| 1467541433 | David S. Cochran | Internal Medicine | 2115 S Fremont Ave Ste 4300, Springfield, MO 65804-2232 | 2006-10-11 |
| 1568559359 | Donald L. Yakel Jr. | Internal Medicine | 747 N Rutledge St Ste 1100, Springfield, IL 62702-6700 | 2006-10-05 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62701 |
Please comment or provide details below to improve the information on CENTRUM CARDIOLOGY, LTD.
| 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.