Organization Active NPI

Center for Vein Restoration TN PLLC

  • Vascular Surgery Physician
  • Chattanooga, TN
National Provider Identifier
1215548375
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
CENTER FOR VEIN RESTORATION TN PLLC
Practice address
1405 Cowart St Ste 321
Chattanooga, TN 37408-1179
Phone
(855) 830-8346
Fax
(240) 473-4321
NPI assigned
Aug 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Khanh Q Nguyen, DONPI 1780627976
Title
President
Phone
(855) 830-8346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1405 Cowart St Ste 321
Chattanooga, TN 37408-1179

Mailing address

7474 Greenway Center Dr Ste 100
Greenbelt, MD 20770-3567
Phone (855) 830-8346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260123001311 TN Part B Supplier - Clinic/Group Practice 8022595784 Receives reassigned benefits from 1 practitioner
Practice locations: Chattanooga, TN

National Provider Directory

National Provider Directory

Locations

6005 Park Ave
Ste 225B
Memphis, TN 38119
Phone (901) 767-4520

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1215548375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7474 GREENWAY CENTER DR STE 100",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703567",
            "telephone_number": "855-830-8346",
            "fax_number": "240-473-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 COWART ST STE 321",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374081179",
            "telephone_number": "855-830-8346",
            "fax_number": "240-473-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR VEIN RESTORATION TN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-12",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KHANH",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "855-830-8346",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.