NPIMap

Organization Active NPI

Vein & Esthetic Centre

  • Vascular Surgery Physician
  • Poplar Bluff, MO
National Provider Identifier
1093941668
Registry record updated Jun 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VEIN & ESTHETIC CENTRE
Practice address
2400 Lucy Lee Pkwy
Suite F
Poplar Bluff, MO 63901-2429
Phone
(573) 651-1882
Fax
(573) 334-5302
NPI assigned
Jun 9, 2009
Organization subpart
Yes
Parent organization
VEIN & ESTHETIC CENTREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 9, 2009

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

Authorized official

Name
Dr. John Thomas Critchlow, M.D.NPI 1326108945
Title
Owner/Manager
Phone
(573) 651-1882

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

2400 Lucy Lee Pkwy
Suite F
Poplar Bluff, MO 63901-2429

Mailing address

3065 William St
Suite 105
Cape Girardeau, MO 63703-6393
Phone (573) 651-1882

National Provider Directory

National Provider Directory
Tax ID family
Veinesthetic Centre2 organizations share this tax ID, including this one
Part of
Veinesthetic Centre

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3065 William St
Ste 105
Cpe Girardeau, MO 63703
Phone (573) 651-1882

2400 Lucy Lee Pkwy
Ste F
Poplar Bluff, MO 63901
Phone (573) 609-2266

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1244505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244505600000",
    "number": "1093941668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3065 WILLIAM ST",
            "address_2": "SUITE 105",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036393",
            "telephone_number": "573-651-1882",
            "fax_number": "573-334-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 LUCY LEE PKWY",
            "address_2": "SUITE F",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012429",
            "telephone_number": "573-651-1882",
            "fax_number": "573-334-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN & ESTHETIC CENTRE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VEIN & ESTHETIC CENTRE",
        "enumeration_date": "2009-06-09",
        "last_updated": "2009-06-09",
        "status": "A",
        "authorized_official_last_name": "CRITCHLOW",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "573-651-1882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; 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.