Jon V. Schellack, M.D. (a Professional Medical Corporation)

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

JON V. SCHELLACK, M.D. (A PROFESSIONAL MEDICAL CORPORATION)

Doing business as

Vascular Clinic

Practice address

5425 Brittany Dr # B
Baton Rouge, LA 70808-9144

Phone

(225) 767-5479

Fax

(225) 767-5147

NPI assigned

Sep 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jon V Schellack, M.D.NPI 1780675736

Title

President

Phone

(225) 767-5479

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vascular Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Baton Rouge Vascular Access ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Baton Rouge, LA
  • NPI 1023542339

  Member Of

  NPD member
• Baton Rouge Vascular Access LLC

  • Vascular & Interventional Radiology Physician
  • Baton Rouge, LA
  • NPI 1669753893

  Member Of

  NPD member

Locations

Practitioners 6

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

• Jon V Schellack, M.D., F.A.C.S.

  • Specialist
  • Baton Rouge, LA
  • NPI 1780675736

  Vascular Surgery

  Medicare reassignment Care Compare group NPD Authorized official
• Madeline Moore Dills, MD

  • Vascular Surgery Physician
  • Baton Rouge, LA
  • NPI 1629538996
  Medicare reassignment Care Compare group NPD
• London Cade Guidry, MD

  • Vascular Surgery Physician
  • Baton Rouge, LA
  • NPI 1841461514
  Medicare reassignment Care Compare group NPD
• Taylor Scott Gwin, MD, MPH

  • Vascular Surgery Physician
  • Baton Rouge, LA
  • NPI 1093974099
  Medicare reassignment Care Compare group NPD
• Wajeeh Irfan, M.D.

  • Vascular Surgery Physician
  • Baton Rouge, LA
  • NPI 1689930356
  Medicare reassignment Care Compare group NPD
• Cindy Granata

  • Family Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1487437372
  Medicare reassignment NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174624712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 BRITTANY DR # B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089144",
            "telephone_number": "225-767-5479",
            "fax_number": "225-767-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 BRITTANY DR # B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089144",
            "telephone_number": "225-767-5479",
            "fax_number": "225-767-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON V. SCHELLACK, M.D. (A PROFESSIONAL MEDICAL CORPORATION)",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHELLACK",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-767-5479",
        "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": "1446564",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vascular Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lionel Jolla, LMSW
• Tiffany Wendling Jolliff, R.T.(R)
• Angelle Leger Jolly, MD
• Larue H Jolly, LCSW
• Jon G Traxler, MD LLC (Job G Traxler, MD)
• Larry A Jonas, PT
• Cheryl Lytra Jones Conner, LPN
• Jones-Antoine Enterprises Company,LLC
• Lisa Darnell Jones-Johnson, LPN
• Regina Jones-Johnson

• Vascular Surgery Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Vascular Surgery Physician in Louisiana

• 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.
• 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.