Organization Active NPI

Vascular Associates, PC

  • Vascular Surgery Physician
  • Chattanooga, TN
National Provider Identifier
1154421428
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VASCULAR ASSOCIATES, PC
Practice address
2515 Desales Ave
Suite 206
Chattanooga, TN 37404-1100
Phone
(423) 629-6550
Fax
(423) 629-0612
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Anthony Bradley Boland, M.D.NPI 1437135373
Title
President
Phone
(423) 629-6550

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

2515 Desales Ave
Suite 206
Chattanooga, TN 37404-1100

Mailing address

PO Box 116976
Atlanta, GA 30368-6976
Phone (423) 629-6550

Other identifiers 4

IdentifierTypeStateIssuer
3721850MedicaidTN
3138958OtherTNBLUECROSS OF TN
AS26943330004OtherTNCIGNA COMM
VAMedicaidTN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154421428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 116976",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303686976",
            "telephone_number": "423-629-6550",
            "fax_number": "423-629-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 DESALES AVE",
            "address_2": "SUITE 206",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041100",
            "telephone_number": "423-629-6550",
            "fax_number": "423-629-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOLAND",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-629-6550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3721850",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS OF TN",
            "identifier": "3138958",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA COMM",
            "identifier": "AS26943330004",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VA",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.