NPIMap

Organization Active NPI

USA Vein Clinics of Maryland LLC

  • Vascular Surgery Physician
  • Lutherville Timonium, MD
National Provider Identifier
1104626647
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
USA VEIN CLINICS OF MARYLAND LLC
Practice address
9515 Deereco Rd Ste 205C
Lutherville Timonium, MD 21093-2153
Phone
(410) 252-6836
NPI assigned
Mar 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Authorized official

Name
Ashley Jackson
Title
Manager
Phone
(323) 350-1204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

9515 Deereco Rd Ste 205C
Lutherville Timonium, MD 21093-2153

Mailing address

304 Wainwright Dr
Northbrook, IL 60062-1900
Phone (323) 350-1204

National Provider Directory

National Provider Directory
Tax ID family
USA Vein Clinics of Maryland LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1104626647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 WAINWRIGHT DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621900",
            "telephone_number": "323-350-1204",
            "fax_number": "224-235-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9515 DEERECO RD STE 205C",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210932153",
            "telephone_number": "410-252-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA VEIN CLINICS OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "323-350-1204"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville Timonium, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.