NPIMap

Organization Active NPI

Regional Vascular & Vein Institute

  • Vascular Surgery Physician
  • North Canton, OH
National Provider Identifier
1003094897
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
REGIONAL VASCULAR & VEIN INSTITUTE
Practice address
6046 Whipple Ave NW Ste 203
North Canton, OH 44720-7616
Phone
(330) 588-8900
Fax
(330) 588-8990
NPI assigned
Feb 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeffrey T Prem, MDNPI 1235110693
Title
President
Phone
(330) 602-7702

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X OH
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X OH Primary

Addresses

Primary practice location

6046 Whipple Ave NW Ste 203
North Canton, OH 44720-7616

Mailing address

6046 Whipple Ave NW Ste 100
North Canton, OH 44720-7616
Phone (330) 588-8900

Other identifiers 1

IdentifierTypeStateIssuer
2267676MedicaidOH

Other names 1

  • Regional Surgical Specialists, Inc Doing business as

National Provider Directory

National Provider Directory

Locations

6046 Whipple Ave NW
Ste 203
North Canton, OH 44720
Phone (330) 588-8900

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586390400000",
    "number": "1003094897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6046 WHIPPLE AVE NW STE 100",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207616",
            "telephone_number": "330-588-8900",
            "fax_number": "330-588-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6046 WHIPPLE AVE NW STE 203",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207616",
            "telephone_number": "330-588-8900",
            "fax_number": "330-588-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL VASCULAR & VEIN INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A",
        "authorized_official_last_name": "PREM",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-602-7702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2267676",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regional Surgical Specialists, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Regional Surgical Specialists, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.