NPIMap

Organization Active NPI

South Atlanta Vascular Institute, LLC

  • Vascular Surgery Physician
  • Stockbridge, GA
National Provider Identifier
1063903078
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
66855 Issued in GA
Legal business name
SOUTH ATLANTA VASCULAR INSTITUTE, LLC
Practice address
4045 Mt. Zion Parkway
Stockbridge, GA 30281
Phone
(770) 919-5238
Fax
(470) 781-5393
NPI assigned
May 24, 2018
Last updated
Sep 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
Dr. David William Allison, MDNPI 1386869535
Title
Managing Member
Phone
(770) 919-5238

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
Vascular & Interventional Radiology Physician 2085R0204X 70519 GA
Vascular Surgery Physician 2086S0129X 66855 GA Primary

Addresses

Primary practice location

4045 Mt. Zion Parkway
Stockbridge, GA 30281

Mailing address

4045 Mt. Zion Parkway
Stockbridge, GA 30281
Phone (770) 919-5238

Other identifiers 3

IdentifierTypeStateIssuer
1386869535MedicaidTN
1598965006MedicaidGA
1760644355MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190430002811 GA Part B Supplier - Clinic/Group Practice 7315289972 Receives reassigned benefits from 5 practitioners
Practice locations: Stockbridge, GA

National Provider Directory

National Provider Directory

Locations

7402 Davidson Pkwy S
Stockbridge, GA 30281
Phone (770) 507-0909

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18188/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/BIJACD

Practitioners & affiliated clinicians

Practitioners 55

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1063903078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 MT. ZION PARKWAY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-919-5238",
            "fax_number": "470-781-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 MT. ZION PARKWAY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-919-5238",
            "fax_number": "470-781-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ATLANTA VASCULAR INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-24",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-08",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "770-919-5238",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "70519",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "66855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386869535",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598965006",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760644355",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.