Active NPI
Vascular Surgery Associates, P.C.
- Vascular Surgery Physician
- Liberty, MO
National Provider Identifier
1235274127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208014100 | Medicaid | MO | |
| 202238903 | Medicaid | MO |
National Provider Directory
National Provider DirectoryLocations
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.