Southern Vein Care

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SOUTHERN VEIN CARE

Practice address

2959 Sharpsburg McCullum Rd
Newnan, GA 30265-2297

Phone

(770) 683-8346

Fax

(770) 916-7642

NPI assigned

Mar 26, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Garnet Roy Craddock Jr., MDNPI 1588646012

Title

Owner

Phone

(770) 683-8346

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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

• Garnet R. Craddock Jr., M.D.

  • Surgery Physician
  • Newnan, GA
  • NPI 1588646012
  Medicare reassignment Care Compare group NPD Authorized official
• Lindsey L Witt, WHNP

  • Surgery Physician
  • Newnan, GA
  • NPI 1275855504
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1184201022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2959 SHARPSBURG MCCULLUM RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652297",
            "telephone_number": "770-683-8346",
            "fax_number": "770-916-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2959 SHARPSBURG MCCULLUM RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652297",
            "telephone_number": "770-683-8346",
            "fax_number": "770-916-7642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1975 Highway 54 W Ste 110",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302694794",
            "country_code": "US",
            "telephone_number": "770-683-8346",
            "fax_number": "770-916-7642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN VEIN CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "CRADDOCK",
        "authorized_official_first_name": "GARNET",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-683-8346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Bone & Joint Ambulatory Surgical Center, LLC
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Pain and Spine Associates, LLC
• Southern Smiles Newnan
• Southside Family Chiropractic LLC
• Meghan Spain
• Kayla Marie Span, OTR/L
• Alexandria Celeste Spates, LAPC
• Spectrum Health Services

• Surgery Physician in Newnan, GA
• Providers in Newnan, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.