CARDIAC KIDS PLLC NPI 1124394556

NPI Information

NPI: 1124394556
Provider Name: CARDIAC KIDS, PLLC
Classification: Pediatrics - 2080P0202X
Entity Type: Organization

Specialization: Pediatric Cardiology

Address:
1330 N RIM DR
SUITE A
FLAGSTAFF, AZ
ZIP 86001
Phone: (928) 779-7014
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CARDIAC KIDS, PLLC is a pediatric cardiology pediatrics in Flagstaff, AZ. The provider is a pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. CARDIAC KIDS, PLLC NPI is 1124394556. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1330 N RIM DR
SUITE A
FLAGSTAFF, AZ
ZIP 86001-134
Phone: (928) 779-7014
Fax: (928) 779-3493

The provider's authorized official is Jeffrey P Rockow .
The authorized official title is Ceo and has the following contact phone number (928) 779-7014.

The enumeration date for this NPI number is 3/29/2012 and was last updated on 8/9/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080P0202X	Pediatrics	Pediatric Cardiology	25161	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	393059	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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