Georgia Interventional and Vascular Specialists, PC

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

042261 Issued in GA

Legal business name

GEORGIA INTERVENTIONAL AND VASCULAR SPECIALISTS, PC

Practice address

264 19TH St NW Ste 2240
Atlanta, GA 30363-1139

Phone

(404) 532-1564

Fax

(404) 532-1565

NPI assigned

Oct 11, 2012

Organization subpart

No

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

Authorized official

Name

Cynthia Jones

Title

Credentialing

Phone

(630) 725-2737

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1255683470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 SPRING RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605233944",
            "telephone_number": "630-725-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 19TH ST NW STE 2240",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303631139",
            "telephone_number": "404-532-1564",
            "fax_number": "404-532-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA INTERVENTIONAL AND VASCULAR SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "630-725-2737"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": "GA",
            "license": "042261",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "042261",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Phlebology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Phlebology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.