NPIMap

Organization Active NPI

Fresenius Vascular Care Pensacola LLC

Doing business as Azura Vascular Care Renalus Pensacola

  • Vascular & Interventional Radiology Physician
  • Pensacola, FL
National Provider Identifier
1285031963
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
FRESENIUS VASCULAR CARE PENSACOLA LLC
Doing business as
Azura Vascular Care Renalus Pensacola
Practice address
1619 Creighton Rd Ste 2
Pensacola, FL 32504-7152
Phone
(850) 466-3843
Fax
(850) 484-3106
NPI assigned
Nov 25, 2014
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Gregg Miller, MDNPI 1942273560
Title
Authorized Official
Phone
(717) 515-4048

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X Primary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X

Addresses

Primary practice location

1619 Creighton Rd Ste 2
Pensacola, FL 32504-7152

Mailing address

PO Box 419076
Boston, MA 02241-9076
Phone (610) 644-8900

Other names 1

  • Azura Vascular Care Renalus Pensacola Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161119000176 FL Part B Supplier - Clinic/Group Practice 0547549263 Receives reassigned benefits from 6 practitioners
Practice locations: Pensacola, FL

National Provider Directory

National Provider Directory
Tax ID family
Fresenius Vascular Care Pensacola LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

214 Covell Rd
Crestview, FL 32539
Phone (850) 864-4005

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1285031963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419076",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022419076",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 CREIGHTON RD STE 2",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325047152",
            "telephone_number": "850-466-3843",
            "fax_number": "850-484-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS VASCULAR CARE PENSACOLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "717-515-4048",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Azura Vascular Care Renalus Pensacola",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.