NPIMap

Organization Active NPI

Vein Specialists of North Carolina, PA

  • Surgery Physician
  • Wilmington, NC
National Provider Identifier
1124225057
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
VEIN SPECIALISTS OF NORTH CAROLINA, PA
Practice address
6752 Rock Spring Road
Suite #200
Wilmington, NC 28405
Phone
(910) 798-5347
Fax
(910) 763-6570
NPI assigned
Jul 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Cynthia Jones
Title
Credentialing
Phone
(630) 725-2737

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

6752 Rock Spring Road
Suite #200
Wilmington, NC 28405

Mailing address

2015 Spring Rd Ste 300
Oak Brook, IL 60523-3944
Phone (630) 725-2700

Other practice location 1

206 Joe Knox Ave Ste H
Mooresville, NC 28117-7912
Phone (704) 684-4511

Other practice location 2

232 Crossroads Blvd
Cary, NC 27518-6893
Phone (919) 859-1276

Other practice location 3

326 S Sharon Amity Rd
Charlotte, NC 28211-2806
Phone (704) 442-2400

Other practice location 4

20 Medical Campus Dr NW Ste 207
Supply, NC 28462-4094
Phone (910) 755-5253

Other identifiers 1

IdentifierTypeStateIssuer
DC3861OtherNCRAILROAD MEDICARE PIN

Other names 1

  • Kamran Goudarzi, MD, PA Former legal business name

National Provider Directory

National Provider Directory

Locations

2001 Butterfield Rd
Ste 300
Downers Grove, IL 60515
Phone (630) 725-2730

232 Crossroads Blvd
Cary, NC 27518
Phone (919) 859-1276

20 Medical Campus Dr NW
Ste 207
Supply, NC 28462
Phone (910) 755-5066

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1124225057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 SPRING RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605233944",
            "telephone_number": "630-725-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6752 ROCK SPRING ROAD",
            "address_2": "SUITE #200",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28405",
            "telephone_number": "910-798-5347",
            "fax_number": "910-763-6570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 Joe Knox Ave Ste H",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281177912",
            "country_code": "US",
            "telephone_number": "704-684-4511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "232 Crossroads Blvd",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275186893",
            "country_code": "US",
            "telephone_number": "919-859-1276",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "326 S Sharon Amity Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282112806",
            "country_code": "US",
            "telephone_number": "704-442-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 Medical Campus Dr NW Ste 207",
            "address_purpose": "LOCATION",
            "city": "Supply",
            "state": "NC",
            "postal_code": "284624094",
            "country_code": "US",
            "telephone_number": "910-755-5253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VEIN SPECIALISTS OF NORTH CAROLINA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "630-725-2737"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "DC3861",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kamran Goudarzi, MD, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.