Vein Clinic LLC

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

Legal business name

VEIN CLINIC LLC

Practice address

3209 W Fullerton Pike
Suite G
Bloomington, IN 47403-4060

Phone

(812) 325-3275

NPI assigned

Sep 10, 2012

Organization subpart

No

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

Authorized official

Name

Kent A Beams, MD

Title

Owner

Phone

(812) 325-3275

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1033468715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 W FULLERTON PIKE",
            "address_2": "SUITE G",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034060",
            "telephone_number": "812-325-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 W FULLERTON PIKE",
            "address_2": "SUITE G",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034060",
            "telephone_number": "812-325-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "BEAMS",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-325-3275",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Phlebology Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Phlebology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.