Organization Active NPI

Vascular Surgery Assoc, PC

  • Vascular Surgery Physician
  • Flint, MI
National Provider Identifier
1154198331
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VASCULAR SURGERY ASSOC, PC
Practice address
5054 W Bristol Rd Ste E
Flint, MI 48507-2952
Phone
(810) 600-2030
NPI assigned
Dec 7, 2023
Organization subpart
Yes
Parent organization
VASCULAR SURGERY ASSOC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Authorized official

Name
Joseph M Jacot, CEO
Title
Chief Executive Officer
Phone
(810) 732-1620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

5054 W Bristol Rd Ste E
Flint, MI 48507-2952

Mailing address

5054 W Bristol Rd Ste E
Flint, MI 48507-2952
Phone (810) 600-2030

Other names 1

  • Innovative Wound Care Specialists Other name

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
23D2296976Innovative Wound Care Specialists5054 W Bristol Road, Flint, MI 48507Certificate of waiverJan 8, 2028

National Provider Directory

National Provider Directory
Tax ID family
Vascular Surgery Assoc PC6 organizations share this tax ID, including this one
Part of
Vascular Surgery Assoc PC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1154198331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5054 W BRISTOL RD STE E",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072952",
            "telephone_number": "810-600-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5054 W BRISTOL RD STE E",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072952",
            "telephone_number": "810-600-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR SURGERY ASSOC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VASCULAR SURGERY ASSOC, PC",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "JACOT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "810-732-1620",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Wound Care Specialists",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Innovative Wound Care Specialists",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.