JACKSON HEART PLLC NPI 1164353009

NPI Information

  • NPI: 1164353009
  • Provider Name: JACKSON HEART PLLC
  • Classification: Internal Medicine - 207RI0011X
  • Specialization: Interventional Cardiology
  • Entity Type: Organization
  • Address: 205 N EAST AVE
    JACKSON, MI
    ZIP 49201
  • Phone: (517) 205-4800

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NPI Details

JACKSON HEART PLLC is an interventional cardiology internal medicine in Jackson, MI. The provider is 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. JACKSON HEART PLLC NPI is 1164353009. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

205 N EAST AVE
JACKSON, MI
ZIP 49201-753
Phone: (517) 205-4800

The provider's authorized official is Husam Shadid .
The authorized official title is Physician Owner and has the following contact phone number (310) 745-6830.

The enumeration date for this NPI number is 5/28/2026 and was last updated on 5/28/2026.

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
1207RI0011XInternal MedicineInterventional CardiologyYes

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: 11/21/2025

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