JACKSON HEART PLLC – NPI #1164353009
Internal Medicine

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 is a provider located in JACKSON, MI. NPPES recently assigned the NPI number 1164353009 to JACKSON HEART PLLC on May 28, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207RI0011X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Interventional Cardiology

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JACKSON HEART PLLC below.

NPI Profile for
JACKSON HEART PLLC

NPI Number
1164353009
Enumeration Date

(about a week ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
JACKSON HEART PLLC
Primary location
205 N EAST AVE
JACKSON, MI 49201-1753
Phone: (517) 205-4800 Fax:
Mailing address
1940 FOUNTAIN VIEW DR # 1282
HOUSTON, TX 77057-3206
Phone: Fax:
Organization Subpart
No
Authorized Official
HUSAM SHADID
PHYSICIAN OWNER
Phone: (310) 745-6830
Updated
Certification Date
May 28, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RI0011X
- Internal Medicine / Interventional Cardiology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.