Carolina Vein Care and Aesthetics, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

CAROLINA VEIN CARE AND AESTHETICS, LLC

Practice address

103 S Venture Dr Ste B
Greenville, SC 29615-3571

Phone

(864) 918-1911

NPI assigned

Jul 10, 2018

Organization subpart

Yes

Parent organization

CAROLINA VEIN CARE AND AESTHETICS, LLCAs reported in NPPES

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

Authorized official

Name

Mark R Jackson, MDNPI 1033177530

Title

Officer

Phone

(864) 918-1911

Specialties & licenses 2

Addresses

Other names 1

• Carolina Vein Care Aesthetics, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Part of

Carolina Vein Care and Aesthetics LLC

Locations

Practitioners 2

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

• Mark R Jackson, MD

  • Vascular Surgery Physician
  • Greenville, SC
  • NPI 1033177530
  Medicare reassignment Care Compare group Authorized official
• Julie U. Park, M.D.

  • Vascular & Interventional Radiology Physician
  • Simpsonville, SC
  • NPI 1336151729
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1134615396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S VENTURE DR STE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153571",
            "telephone_number": "864-918-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S VENTURE DR STE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153571",
            "telephone_number": "864-918-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA VEIN CARE AND AESTHETICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINA VEIN CARE  AND AESTHETICS, LLC",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "864-918-1911",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2471V0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular-Interventional Technology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Vein Care Aesthetics, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolina Rehab & Mobility
• Carolina Sleep Therapy LLC
• Carolina Spine & Health Inc.
• Carolina Spine & Rehab LLC
• Carolina Urgent Dental Care
• Carolina'S Eye Care, P.a.
• Carolinas Center for Advanced Management of Pain, PA
• Carolinas Center for Dental Implants
• Carolinas Fertility Institute, P.a.
• Carolinas Medical Center

• Vascular Surgery Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Vascular Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.