Organization Active NPI

Preferred Vascular Services Akron, LLC

  • Vascular Surgery Physician
  • Munroe Falls, OH
National Provider Identifier
1114604105
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
PREFERRED VASCULAR SERVICES AKRON, LLC
Practice address
43 S Main St Ste 1
Munroe Falls, OH 44262-1635
Phone
(234) 349-8100
Fax
(239) 597-2313
NPI assigned
Jun 30, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Offiical
Phone
(615) 234-5954

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

43 S Main St Ste 1
Munroe Falls, OH 44262-1635

Mailing address

9140 Corsea del Fontana Way
Naples, FL 34109-4397
Phone (239) 597-2010

Other practice location 1

43 S Main St Ste 2
Munroe Falls, OH 44262-1635
Phone (234) 349-8100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250108003948 OH Part B Supplier - Clinic/Group Practice 1850829565 Receives reassigned benefits from 3 practitioners
Practice locations: Munroe Falls, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2289661Preferred Vascular Services Akron, LLC43 S Main Street, Ste 1, Munroe Falls, OH 44262Certificate of waiverSep 12, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1688083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1114604105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9140 CORSEA DEL FONTANA WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341094397",
            "telephone_number": "239-597-2010",
            "fax_number": "239-597-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 S MAIN ST STE 1",
            "city": "MUNROE FALLS",
            "state": "OH",
            "postal_code": "442621635",
            "telephone_number": "234-349-8100",
            "fax_number": "239-597-2313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 S Main St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Munroe Falls",
            "state": "OH",
            "postal_code": "442621635",
            "country_code": "US",
            "telephone_number": "234-349-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREFERRED VASCULAR SERVICES AKRON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-30",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFIICAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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 Munroe Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.