So Vein Diagnostics LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SO VEIN DIAGNOSTICS LLC

Practice address

6045 Creekford Dr
Lithonia, GA 30058-7960

Phone

(404) 965-0775

NPI assigned

Feb 2, 2023

Organization subpart

No

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

Authorized official

Name

Markia MaddoxNPI 1063109783

Title

Director of Laboratory

Phone

(404) 965-0775

Specialties & licenses 1

Addresses

Practitioners 1

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

• Markia Maddox

  • Health Service Clinic/Center
  • Lithonia, GA
  • NPI 1063109783
  NPD Authorized official

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1164128997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MALL PKWY # 1573",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6045 CREEKFORD DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587960",
            "telephone_number": "404-965-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SO VEIN DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2024-03-26",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "MARKIA",
        "authorized_official_title_or_position": "DIRECTOR OF LABORATORY",
        "authorized_official_telephone_number": "404-965-0775"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robbin Smith, FIRST ASSISTANT
• Shatara Smith
• Sheila Denise Smith, LPC
• Victoria Marshelle Smith
• Y'NA R Snipes, DOULA
• Chloe Sondler, DPT
• South Dekalb Center for Healthy Living
• Southeast Atlanta Vascular Care, LLC
• Southeast Atlanta Vascular Care, LLC
• Southeast Atlanta Vascular Care, LLC

• Health Service Clinic/Center in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Health Service Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.