NPIMap

Organization Active NPI

Varicosity LLC

  • Vascular Surgery Physician
  • Birmingham, AL
National Provider Identifier
1114968575
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VARICOSITY LLC
Practice address
2704 20TH St S
Suite 410
Birmingham, AL 35209-1924
Phone
(205) 592-1800
Fax
(205) 592-1752
NPI assigned
Jun 9, 2006
Reactivated
Nov 12, 2009
Last updated
Jul 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Authorized official

Name
Dr. Carlton Duane Randleman Jr., MDNPI 1487693982
Title
President
Phone
(205) 592-1800

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 SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

2704 20TH St S
Suite 410
Birmingham, AL 35209-1924

Mailing address

2704 20TH St S
Suite 410
Birmingham, AL 35209-1924
Phone (205) 592-1800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040920000248 AL Part B Supplier - Clinic/Group Practice 3678541596 Receives reassigned benefits from 31 practitioners
Practice locations: Auburn, AL; Homewood, AL; Montgomery, AL

National Provider Directory

National Provider Directory

Locations

1935 E Glenn Ave
Auburn, AL 36830
Phone (334) 539-8049

1935 E Glenn Ave
Ste 200
Auburn, AL 36830

1935 E Glenn Ave
Ste 202
Auburn, AL 36830

2704 20th St S
Ste 410
Birmingham, AL 35209

880 Montclair Rd
Ste 276
Birmingham, AL 35213

2704 20th St S
Homewood, AL 35209

1041 Balch Rd
#375
Madison, AL 35758
Phone (205) 383-1723

1950 Berryhill Rd
Montgomery, AL 36117
Phone 2055921800209

2100 Chestnut St
Ste B
Montgomery, AL 36106

445 Cotton Gin Rd
Montgomery, AL 36117

102 Medical Center Dr
Ste C
Prattville, AL 36066

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438128000000",
    "number": "1114968575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 20TH ST S",
            "address_2": "SUITE 410",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352091924",
            "telephone_number": "205-592-1800",
            "fax_number": "205-592-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 20TH ST S",
            "address_2": "SUITE 410",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352091924",
            "telephone_number": "205-592-1800",
            "fax_number": "205-592-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARICOSITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2015-07-29",
        "deactivation_date": "2007-08-21",
        "reactivation_date": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "RANDLEMAN",
        "authorized_official_first_name": "CARLTON",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-592-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.