Southeast Vascular Group LP

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME35697 Issued in FL

Legal business name

SOUTHEAST VASCULAR GROUP LP

Practice address

4800 N 9TH Ave
Pensacola, FL 32503-2447

Phone

(850) 429-0102

Fax

(850) 429-0830

NPI assigned

Dec 9, 2005

Organization subpart

No

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

Authorized official

Name

Layne R. Yonehiro, MDNPI 1083699276

Title

President

Phone

(850) 429-0102

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in FL, AL2 enrollments

Enrollment records 2

Tax ID family

Southeast Vascular Group LP3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Southeast Vascular Group LP

  • Surgery Physician
  • Gulf Breeze, FL
  • NPI 1295302990
  NPD tax ID
• Southeast Vascular Group LP

  • Surgery Physician
  • Pensacola, FL
  • NPI 1487221180
  NPD tax ID

Locations

Practitioners 6

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

• Layne R. Yonehiro, MD

  • Surgery Physician
  • Pensacola, FL
  • NPI 1083699276

  AL

  Medicare reassignment NPD Authorized official
• Jon Christian Allmon, MD

  • Vascular Surgery Physician
  • Jacksonville, FL
  • NPI 1831174044
  NPD (past)
• Fernando E. Kafie, MD

  • Vascular Surgery Physician
  • Pensacola, FL
  • NPI 1790760478
  NPD (past)
• Lorrie W. Knapp, ARNP

  • Nurse Practitioner
  • Pensacola, FL
  • NPI 1316198609
  NPD (past)
• Teresa Marie Foss, APRN

  • Primary Care Nurse Practitioner
  • North Las Vegas, NV
  • NPI 1891770004
  NPD (past)
• Stuart A. Harlin, M.D.

  • Vascular Surgery Physician
  • Katy, TX
  • NPI 1568435618
  NPD (past)

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1184609372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30090",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325031090",
            "telephone_number": "850-429-0102",
            "fax_number": "850-429-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032447",
            "telephone_number": "850-429-0102",
            "fax_number": "850-429-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST VASCULAR GROUP LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "YONEHIRO",
        "authorized_official_first_name": "LAYNE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-429-0102",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME35697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH FIRST NETWORK",
            "identifier": "0329",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266355400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CK8716",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529931590",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529913680",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529929230",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Southeastern Osteoporosis Services Inc
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• Southern Home Care Services, Inc.

• Surgery Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.