Organization Active NPI

Raleigh Vein & Laser Center PA

  • Vascular Surgery Physician
  • Raleigh, NC
National Provider Identifier
1104001742
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
200001800402 Issued in NC
Legal business name
RALEIGH VEIN & LASER CENTER PA
Practice address
2011 Falls Valley Dr Ste 104
Raleigh, NC 27615-3452
Phone
(919) 866-0002
Fax
(919) 866-0230
NPI assigned
Jan 2, 2008
Last updated
Jun 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Authorized official

Name
Dr. Janice Hong Messier, M.D.NPI 1699836395
Title
Owner
Phone
(919) 866-0002

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 Surgery Physician 2086S0129X 200001338614 NC
Vascular Surgery Physician 2086S0129X 200001800402 NC Primary

Addresses

Primary practice location

2011 Falls Valley Dr Ste 104
Raleigh, NC 27615-3452

Mailing address

2011 Falls Valley Dr Ste 104
Raleigh, NC 27615-3452
Phone (919) 866-0002

Other practice location 1

10000 Falls Of Neuse Rd.
Suite 303
Raleigh, NC 27614
Phone (919) 866-0002

Other identifiers 2

IdentifierTypeStateIssuer
1699836395OtherIND NPI
89136P2MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721000174 NC Part B Supplier - Clinic/Group Practice 6204816325 Receives reassigned benefits from 1 practitioner
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

10000 Falls of Neuse Rd
Ste 303
Raleigh, NC 27614
Phone (919) 866-0002

2011 Falls Valley Dr
Raleigh, NC 27615
Phone (847) 736-4924

2011 Falls Valley Dr
Ste 104
Raleigh, NC 27615
Phone (919) 866-0002

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1104001742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 FALLS VALLEY DR STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153452",
            "telephone_number": "919-866-0002",
            "fax_number": "919-866-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 FALLS VALLEY DR STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153452",
            "telephone_number": "919-866-0002",
            "fax_number": "919-866-0230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10000 Falls Of Neuse Rd.",
            "address_2": "Suite 303",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "27614",
            "country_code": "US",
            "telephone_number": "919-866-0002",
            "fax_number": "919-866-0230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RALEIGH VEIN & LASER CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "MESSIER",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "HONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-866-0002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "200001338614",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "200001800402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND NPI",
            "identifier": "1699836395",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89136P2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.