Organization Active NPI

Vein Center of Georgia at Saint Joseph'S, LLC

  • Vascular Surgery Physician
  • Atlanta, GA
National Provider Identifier
1174802003
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VEIN CENTER OF GEORGIA AT SAINT JOSEPH'S, LLC
Practice address
5669 Peachtree Dunwoody Rd NE
Suite 155
Atlanta, GA 30342-1786
Phone
(404) 246-0404
Fax
(404) 847-0423
NPI assigned
Aug 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Authorized official

Name
Mr. Ronald D Reed
Title
Vice President
Phone
(678) 843-5773

Specialties & licenses 1

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

Addresses

Primary practice location

5669 Peachtree Dunwoody Rd NE
Suite 155
Atlanta, GA 30342-1786

Mailing address

1838 American Way
Lawrenceville, GA 30043-6611
Phone (770) 995-7622

National Provider Directory

National Provider Directory

Locations

5669 Peachtree Dunwoody Rd
Ste 155
Sandy Springs, GA 30342
Phone (404) 246-0404

NPI Registry JSON

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1174802003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1838 AMERICAN WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436611",
            "telephone_number": "770-995-7622",
            "fax_number": "770-995-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5669 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 155",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421786",
            "telephone_number": "404-246-0404",
            "fax_number": "404-847-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN CENTER OF GEORGIA AT SAINT JOSEPH'S, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "678-843-5773",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.