Charleston Vascular Surgery, P.C.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

CHARLESTON VASCULAR SURGERY, P.C.

Practice address

1280 Hospital Drive, Suite 302
Charleston Vascular Surgery, P.C.
Mount Pleasant, SC 29464-1901

Phone

(843) 884-9900

Fax

(843) 936-6699

NPI assigned

Aug 30, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Rick M. Roberts, M.D.

Title

Co-President

Phone

(843) 884-9900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1043766017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2024",
            "address_2": "CHARLESTON VASCULAR SURGERY, P.C.",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294652024",
            "telephone_number": "843-884-9900",
            "fax_number": "843-936-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 HOSPITAL DRIVE, SUITE 302",
            "address_2": "CHARLESTON VASCULAR SURGERY, P.C.",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294641901",
            "telephone_number": "843-884-9900",
            "fax_number": "843-936-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON VASCULAR SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "843-884-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.