NPIMap

Organization Active NPI

Newnan Vascular Center, LLC

  • Medical Specialty Clinic/Center
  • Newnan, GA
National Provider Identifier
1144540519
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
NEWNAN VASCULAR CENTER, LLC
Practice address
2690 Highway 34 E Ste a
Newnan, GA 30265-1330
Phone
(727) 474-0090
Fax
(727) 474-0098
NPI assigned
Jun 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Authorized official

Name
Janet R. Dees, RN
Title
Mananging Member
Phone
(727) 474-0090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

2690 Highway 34 E Ste a
Newnan, GA 30265-1330

Mailing address

3001 Palm Harbor Blvd Ste a
Palm Harbor, FL 34683-1930
Phone (727) 474-0090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100927001299 GA Part B Supplier - Clinic/Group Practice 7113043167 Receives reassigned benefits from 5 practitioners
Practice locations: Newnan, GA

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 5

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": "1275955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522886400000",
    "number": "1144540519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 PALM HARBOR BLVD STE A",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831930",
            "telephone_number": "727-474-0090",
            "fax_number": "727-474-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 HIGHWAY 34 E STE A",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651330",
            "telephone_number": "727-474-0090",
            "fax_number": "727-474-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWNAN VASCULAR CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-08",
        "last_updated": "2018-04-05",
        "status": "A",
        "authorized_official_last_name": "DEES",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "MANANGING MEMBER",
        "authorized_official_telephone_number": "727-474-0090",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.