Organization Active NPI

Vascular Surgery Associates, P.C.

  • Vascular Surgery Physician
  • Liberty, MO
National Provider Identifier
1235274127
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VASCULAR SURGERY ASSOCIATES, P.C.
Practice address
2521 Glenn Hendren Dr
Suite 112
Liberty, MO 64068-3388
Phone
(816) 781-5006
Fax
(816) 781-9212
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Authorized official

Name
Dr. Mike L. Waldschmdit, M.D.
Title
President
Phone
(816) 781-5006

Specialties & licenses 1

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

Addresses

Primary practice location

2521 Glenn Hendren Dr
Suite 112
Liberty, MO 64068-3388

Mailing address

2521 Glenn Hendren Dr
Suite 112
Liberty, MO 64068-3388
Phone (816) 781-5006

Other identifiers 2

IdentifierTypeStateIssuer
208014100MedicaidMO
202238903MedicaidMO

National Provider Directory

National Provider Directory

Locations

19550 E 39th St S
Ste 220
Independence, MO 64057
Phone (816) 461-6837

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1235274127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 GLENN HENDREN DR",
            "address_2": "SUITE 112",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683388",
            "telephone_number": "816-781-5006",
            "fax_number": "816-781-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 GLENN HENDREN DR",
            "address_2": "SUITE 112",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683388",
            "telephone_number": "816-781-5006",
            "fax_number": "816-781-9212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR SURGERY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "WALDSCHMDIT",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-781-5006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208014100",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202238903",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.