NPIMap

Organization Active NPI

Vascular Solutions PC

  • Vascular Surgery Physician
  • Charlotte, NC
National Provider Identifier
1215973672
Registry record updated Dec 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VASCULAR SOLUTIONS PC
Practice address
7800 Providence Rd
Suite 209
Charlotte, NC 28226-2986
Phone
(704) 544-7535
Fax
(704) 544-7570
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2020

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

Authorized official

Name
Dr. Peter Frederick Ford, MDNPI 1891917431
Title
President
Phone
(704) 544-7535

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: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

7800 Providence Rd
Suite 209
Charlotte, NC 28226-2986

Mailing address

7800 Providence Rd
Suite 209
Charlotte, NC 28226-2986
Phone (704) 544-7535

Other identifiers 4

IdentifierTypeStateIssuer
330004500OtherNCRAILROAD MEDICARE
182328MedicaidSC
76713OtherNCBCBS NC
8976713MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060807000291 NC Part B Supplier - Clinic/Group Practice 3971515271 Receives reassigned benefits from 4 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

7800 Providence Rd
Ste 209
Charlotte, NC 28226
Phone (704) 544-7535

209 S College St
Heath Springs, SC 29058
Phone (803) 273-4018

1228 Colonial Commons Ct
Ste 205
Lancaster, SC 29720
Phone (803) 283-2011

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608768000000",
    "number": "1215973672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 PROVIDENCE RD",
            "address_2": "SUITE 209",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282262986",
            "telephone_number": "704-544-7535",
            "fax_number": "704-544-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 PROVIDENCE RD",
            "address_2": "SUITE 209",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282262986",
            "telephone_number": "704-544-7535",
            "fax_number": "704-544-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR SOLUTIONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-544-7535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "330004500",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182328",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "76713",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8976713",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.